HomeMy WebLinkAbout1991-Plumbing (city rehab)/`'~ CITY OF OSHKOSH N4 25595
PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
OWNER
DESIGN
USE/NATURE OF WORK ~~
PLAN NO.
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type Volts
Fixtures Switches Receptacles Circuits
Amps
PLUMBING CONTRACTOR
-BT -WH
Lav - Sh
- WC - FDr
Sink LTub
Other
/_ ~i
- DW
SP
- Eject
- WSoft
- DF
- Ur
- SS
- CBasin
-San. Sewer_
-Storm Sewer
-Water
FEES: Valuation $ ~~ ~ ~ •'p ~ Permit Fee Paid $ ~ °~ ` ~ °
Park Dedication $
ISSUED BY_ ~ /O
Date 3 '~ ~/ Final/O.P, f b -/ ~ - `~'/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~ D 3
A EN NER
DATE
ADDRESS
TELEPHONE #
ADDRESS ~~~~
OWNER ---~~
NATURE OF WORK _
1VF:T1
PLUMBING PERMIT APPLICATION
~Q ~-- DATE ~ - ~ ~- ~~~ PERMITS ~ ~~ ~~~
PLUMBER
RF.T.A RFPATR INTERIaR
SAN SEW ~ ~
WATER Bathtub Catch Basin
Lavato Grease Trap
Toilet Sum Pum
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink other Site Drain
/ ~ ~~ , Shower /' Laundry Stand Pipe
Floor Drain Laund Tra
Dis osal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
/ Future outlets
~°~~~ L ~'
** V"olation note on the reverse side
~~~ ~ ~
~K iv._?7
Z~G'' ~