HomeMy WebLinkAbout0017404-Plumbing C4-0) CITY OF OSHKOSH N° 17404
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG$ SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 42 5/V Jr- e' Lam PLAN NO.
OWNER /e' i
DESIGNER
USE /NATURE OF WORK /73 P c� /�o,, (�C.M
d ages /4 gle.. yl W..-^
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
AP
PLUMBING CONTRACTOR i 9 4
BT WH j__ Disp WSoft CBasin
Lav Sh 4_ DW DF San. Sewer
WC FDr SP Ur Storm Sewer
j Sink LTub Eject SS Water
Other
FEES: Valuation C� Permit Fee Paid Pd/ Park Dedication
ISSUED BY /L/ Date .3 477..4__ Final /O.P. .3 PO
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 1 K/ 3/
AGENT /OWNER DATE
ADDRESS
TELEPHONE
PLUMBING PERMIT APPLICATION PENT 17yb 7
DATE
ADDRESS are N .4 •LUMBER
OWNER K //a.,,
OF WOR .4r
NATURE INTERIOR
RELAY 111111 Catch Basin
athtub NO Grease Basin SAN SEW avato Sump Pum•
WATER Toilet Local Waste
STORM SEW DATE Site )rain
DATE INSPECTION aSink(other) NM Laundry tan. pipe
N p CTIO/N <dc .Shower NM Laundry Tray
f i��o J 7- f ■Floor Drain -Lat. So tner
�vyi�• /0 Disposal D. Fountain
.2) ,Ow /re /Reck 3 -„,p, Dishwasher 1111111 Ejector
el Yege -Future outlets
3� /TQSe s�r
14/1/1,4- maw
/tafrom. ide
Violation notes on reverses