HomeMy WebLinkAbout0043677-Plumbing (renew #36189) CITY OF OSHKOSH N 43677
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG, SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 1 .A 4 4 //,,,,e
./A1 PLAN NO.
OWNER
DESIGNER
USE/NATURE OF WORK i__e-z-c_c,, -�Z 3 c /,,f--
U rc7
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'
BT WH Disp WSoft CBasin C_
Lav Sh DW DF _San. Sewer
I WC FDr __SP Ur _Storm Sewer
i_ Sink LTub Eject SS Water
Other
FEES: Valuation Permit Park Dedication
ISSUED BY Date /7 S Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE c).2/k5—
7 6ATE
AGENT /OWNER PATE
ADDRESS 5 %/4 7 Z1-4 f 2///57/ rg3 -,50!(.67
TELEPHONE
11.- PERMIT APPLICATION
ADDRESS, I
ky
ere- D.
t DATE 7S PERMIT* 7
OWNER -S ,c_-�� PLUMBER b --e.
NATURE OF WORK 4..2 ai. mss 4 A..... 7
NEW RELAY REPkIR INTERIOR
SAN SENT
WATER Bathtub Sump Pump
$TORN SEW 1 Lavatory Ejector
1 Toilet Water Softener
INSPECTION DATE INSPECTION DATE Kit. Sink Drinkin Fountain
1 Sink(othert,}& Urinal
k N l Waterheater Slop Sink
V 1 Shower Grease Tray
Floor Drain Local Waste
F 2 Laundry Tub Site Drain
Disposal Laundry Standpipe
Dishwasher Catch Basin
tes on the reverse side]
/0 I
Aar
1
1
.°1(1/ <Pr
r��