HomeMy WebLinkAbout0019768-Plumbing (interior) CITY OF OSHKOSH N2 19768
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG A r SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /3_z N 14L 14 - _ PLAN NO.
OWNER w /14u 4zZ
DESIGNER ))
USE /NATURE OF WORK L + .S
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 t ? - ; 7 1 .....„. „.-----
Fixtures Switches Receptacles Circuits
/ - t l
PLUMBING CONTRACTOR _
Z BT " WH Disp WSoft CBasin
Z' Lav Sh DW DF San. Sewer
Z INC FDr SP Ur Storm Sewer
L Sink A L LTub /� Eject SS Water
Other / '1C4) ��"-�'�'
FEES: Valuation $ %S .0 0 Permit Fee Paid $ V1.00 i/ Park Dedication $
ISSUED BY CI- Date g— 3 4.a Final /O.P. 37q19/
9 /
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .i.: A .�.G i , —. Z-/ it �� ..f g 3 -9
/ / / AGENT /OW R DATE
ADDRES
TELEPHONE #
/� PLUMBING PERMIT APPLICATION �
ADDRESS ' 4)4/t,' / DATE g — 3 — !'e P RMIT# /9 7 C y
O
OWNER / d4 4 PLUMBER ' r r''''
NATURE OF WORK /vkv S K
NEW RELAY REPAIR INTERIOR
SAN SEW
STORM SEW '._Bathtub /1 WATER
Basin
1 —Lavatory // Grease Trap
INSPECTION DATE INSPECTION DATE 1 Kit. Sink // / Loma Pump /
/ Local Waste
0 G D K °� - ,2 _ Sink(other) Site Drain
Shower / Laundry Stand Pipe/
Ir. c` , f' ` ; " /4- -../ / Floor Drain
/ / Laundry Tray /
Disposal Wat. Softner
5-- Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
f** Violation notes on the reverse side]