HomeMy WebLinkAbout0040439-Plumbing (interior) 5107
CITY OF OSHKOSH N 40439
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG T SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 5
d/(O Gi`2'rt �.--("et PLAN NO.
OWNER --r._f--e-
DESIGNER
USE /NATURE OF WORK
f.-----e-,-
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
v
PLUMBING CONTRACTOR f 1� Ar
BT WH I 7 Disp WSoft CB sin
3 Lav 2- Sh DW DF San. Sewer
7 WC t FDr L SP Ur Storm Sewer
Sink LJ ab Eject SS Water
Other
76 y C
FEES: Valuation ga 0,6 0 Permit Fee Paid 0 Park Dedication
ISSUED BY G7. Date 0 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE J LL 7 J1 `N
AGENT /OWNER DATE
ADDRESS S ii. g)c-C,M -14 4-n, 73 d S
G TELEPHONE
11 1:INC ERIIIT APPLICATION
ADDRESS /it DATI: 3 i 7` I i``�
OWNER p /7/
NATURE of WORE F
NEW RELAY REPAIR uSSOR
SAN SEW
WATER Bathtub Sump Pump
V A Laveto Ejector
El Toilet E Water Softener
it 4 DATE INSPECTION DATE Kit. Sink
Drinkin• Fountain
R. $iak( other
Urinal Waterheater Slop Sink
Shower r Grease Trap
vl Floor Drain Local Waste
i', //3 /7 Y Laundry Tub Site Drain
6/x,6 Disposal Laundry Standpipe
v\ Dishwasher Cat h Basin i, i
F 7/ qp,,z,„,/,, _________e_______t_, /v 9- 1"/"
Violation notes on the reverse side1