HomeMy WebLinkAbout0020548-Plumbing (interior) 4) CITY OF OSHKOSH N9 20548
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG i] SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS /7s— C r. Ct, PLAN NO.
OWNER k0+"-
DESIGNER
USE /NATURE OF WORK /e -n'
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 Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR c--- a g 6 00-V%-.
BT —L WH
Disp WSoft CBasin
g Lav Sh g DW DF San. Sewer
k INC FDr SP Ur Storm Sewer
Sink gJrFttb/I, C.) Eject SS Water
Other
FEES: Valuation a ,(21- Permit Fee Paid °g"49a 43 (3 Park Dedication
ISSUED BY e- u Z Date 4.7° Final /O.P. 1 4 5 -1
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .-11 C2
AGENT /OWNER DATE
ADDRESS 55 3 1 Ae-- rnet,n 4(p. 7 3U 0 o (4(
TELEPHONE
PLUMBING PERMIT APPLICATION
ADDRESS /7-S' DATE 9 "��C 2'0 P �O `�f‘�
OWNER d� C� L --P--! c- PLUMBER %K e-QO (0..../
NATURE OF WORK /0, Z
NEW RELAY REPAIR INTERIOR
SAN SEW
WATER Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE g Kit. Sink Local Waste
H 6- .O /1 /s /2) Sink(other) Site Drain
Shower Laundry Stand Pipe
l I. I IP t o2- Floor Drain Laundry Tray
S Disposal Wat. Softner
r 9 Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
1) 3 GJ L /3i
d rJ
r** Violation notes on the reverse sidel
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