HomeMy WebLinkAbout0042497-Plumbing (interior) 5 4
CITY OF OSHKOSH N 42497
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC p PLBG) SIGN ZONING FLOOD PLAIN HEIGHT
K s
ADDRESS K 4 b PLAN NO.
lil OWNER
DESIGNER A�
USE /NATURE OF WORK /!i -CJ' t
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 y
I BT WH Disp WSoft CBasi
Lav I
Sh DW DF San. Sewer
WC J FDr SP Ur Storm Sewer
Sink J k) Eject SS Water
Other
FEES: Valuation $r* o a Permit Fee Paid V r- a I Park Dedication
ISSUED BY Date /3 Final /O.P.
In the performance of thi work I agree to perfo a,i ork pursuant to rules governing the described construction.
SIGNATURE `�j f/
AGEN /OWNER DATE
ADDRESS `7 5d /2. e�` ;/i.
TELEPHONE
S ING PERMIT APPLICA 0
f
ADDRESS, ID i� G 7 9 T# 5 7,2 �77
OWNER PLDl M
NATURE OF WORK /t/s�
NEW RELAY REPAIR if INTERIOR
SAN SEW
'DATER Bathtub 1 Su Pu
A, Y Lavato E'ector
2 Toilet 1i Water Softener
INSPECTION DATE INSPECTION DATE I Kit. Sink Drinkin g Fountain
Sink(other) Urinal
I, Waterheater I Slop Sink
,Shower Grease Trap
G 1/ l 7 ,Floor Drain 1 Local Waste
V l Laundry Tub Site Drain
Disposal Laundry Standpipe
7"-- f 6) J` shwasher l Catch Basin
V im D', ,a t
LA (S
n notes on the reverse sidel