HomeMy WebLinkAbout0040465-Plumbing CITY OF OSHKOSH N ° - 40465
4 PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG1 SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS $ 3 7 PLAN NO.
OWNER O -'7 "'" it.
DESIGNER /
USE /NATURE OF WORK /4 � .._ __f_ i/
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 p Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR /7e )------ /
BT WH / � Disp _ WSoft _ CBasin
Lav _ Sh _L DW _ DF _ San. Sewer
WC _ FDr SP _ Ur _ Storm Sewer
Sink _ LTub _ Eject — SS _ Water
Other
FEES: Valuation $ Q " o d Permit Fee 2 - G5 t/ � / ee Paid $ ��Park Dedication $
ISSUED BY /e./ Date Final /O.P.
In the performance of th' work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE `' � ��
AGENT /OWNER DATE
ADDRESS
TELEPHONE N
../ PLL NG PERMIT APPLICATION
ADDRESS, g: /����� A DATE �1 KC _S ----
PEB1�T# T`_
OWNER ../.• • i .0 " .
i �
NATURE OF WORK i '' - - ' `� i
NEW RELAY REPAIR INTERIOR
SAN SEW- # #
STATER - Bathtub
�. Sumv Punm
Lavato E'ector
Toilet A —.Ea Water Softener
DATE INSPECT/ON DATE f Kit. Sink Drinking Fountain
Sink(other)
// Y aS , Urinal
Waterheater
# 7 /6 Slop Sink
I ,Shower Grease Trap
Floor Drain
Local Waste
' Laundry Tub
Site Drain
/ Disposal Laundry Standpipe
f Dishwasher Catch Basin
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