HomeMy WebLinkAbout0041296-Plumbing (interior) CITY OF OSHKOSH N9 41236
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG Fr SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS f-§7. c C/` PLAN NO.
OWNER f S
DESIGNER
USE /NATURE OF WORK /1/5,
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
BT WH Disp WSoft CBasin
2" Lay p Sh DW DF San. Sewer
c? WC L FDr 1 SP Ur Storm Sewer
L Sink -LT�I} i ti-Cg/ Eject SS Water
Other
p- A/
FEES: Valuation 3 D -6 O d Permit Fee Paid S-" c 6 Park Dedication
ISSUED BY__________________ D Final /O.P. 915
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
ft
SIGNATU' .i. _v Id g Fr
f AGENT /OWNER DATE
ADDRESS r' 7 v( a w�Yi 1' �,S 7l 13
Z'� rat 7 J S TELEPHONE N
PLUMBING PERM.:? AP LIGATION i
ADDRESS. /Sc., DATE Y''t g 7 PER CT# V 4.296
OWNER `S
NATURE OF WORK ,-LAS 41'1 -r
NEW RELAY REPAIR r. ■i RI OR
SAN SEW
WATER l Bathtub
SUITD Pu o
NM Ejector
oilet Water Softener
4 vie ON DAZE INSPECTION DATE Sit. Sink Drinkin Fountain
u GP -1 Sink other Urinal
t Waterheater I Slop Sink
K' 7/? 7 r Shower Grease Trap
Floor Drain/ Local Waste
Laundry Tub Site Drain
1 Laundry Standpipe/
9//s--/ �t Dishwasher Catc •n
(1 (..5 wW7/71111/ 7111)
not on the reverse side