HomeMy WebLinkAbout0043640-Plumbing (interior) (4110 CITY OF OSHKOSH N °- 43640
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBGAr SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS � / K 7 i_J2 PLAN NO.
//
OWNER -��'k ,
DESIGNER
USE/NATURE OF WORK ,4/ A
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 j_ WH _ Disp _ WSoft _ CB- A
.2 ^ Lav Sh _1 DW _. DF ._ San. Sewer
y WC I FDr _I_ SP _ Ur _Storm Sewer
Sink - L-Itib /1- C �ji, _ Eject _ SS __ Water
Other
FEES: Valuation 36 6 d ' G 4 , ('= G
$ Permit Fee Paid $ 7/3 Park Dedication $
ISSUED BY Date CA�
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE rijart.--,_
/ AGENT /OWNER DATE
ADDRESS -5752) di, ed,,,,�„ a( � L..�. 23::, `
TELEPHONE #
iPL PEWIT APPLICATION �� O
ADDRESS. 3 / Lg -e-)2� DATE . / /�/ / 4 Puma* # . r"S'C c76
I i ■Geh PLUMBER • °
OWNER , � � =�-
NATURE OF WORK A l /f/ ------ t A
NEW RELAY REPAIR INTERIOR 1 _00=-
SAN SEW
'STATER ,L #
Bathtub // Sump Pump 1
• ; 4 A. J Laveto (1 E' ector
,J- Toilet Water Softener
INSPECTION DATE INSPECTION DATE bae Kit. Sink / Drinkin Q Fountain
Sink(other) Urinal
Waterheater / Slop Sink
Shower Grease Trap
C C 1 Floor Drain / Local Waste
/ 1 / Laundry Tub Site Drain
/( D Disposal 1 Laundry Standpipe /
J� I (/ .5// Dishwasher 2 Catch Basin
rte-- t (X
** on notes on the reverse side]