HomeMy WebLinkAbout1991-PlumbingCITY OF OSHKOSH N° 23171
PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS
~c~ 7 0
PLAN NO.
OWNER ~ ~•~
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures Switches Receptacles
PLUMBING CONTRACTOR
BT - WH
.~ Lav ~ Sh
` WC - FDr
-Sink - LTub
Other
Heat Loss BTU'S
Volts Amps
Circuits
- Disp
DW
~ SP
-Eject
- WSoft
DF
Ur
- SS
- CBasin
-San. Sewer_
-Storm Sewer
Water
FEES: Valuation $ ~ ~ o ~- ~ ~ ~ Permit Fee Paid $ 'z®' `~ ~ Park Dedication $
ISSUED BY ~ ~ Date S^ "~ 9~ Final/O.P. `~ Tg~!
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
ADDRESS
AGENT/OWNER
~~-/ ~ 9/
DATE
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS ~~ 7v ~ DATE ~ ' ~ Y -ny U PERMIT~k `~ ~~ 70
OWNE R ~ ~z~- 2 PLUMBER 9' r `
NATURE OF WORK ~IG'~4~~v~-~-,- -
NEW RELAY REPAIR TNTRRTnR
SAN SEW ~k .~~
WATER / Bathtub G~. / Catch Basin
TORM SEW / Lavator / Grease Trap
Toilet / Sum Pum
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
n 1
~ ~ _ ~~// ~9o Sink(other) Site Drain
^
p~ / Shower Laundry Stand Pipe
c/ ~~ , 9/ Floor Drain Laundr Tray
T Dis osal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
rivals Future outlets
*~ Violation notes on the reverse side