HomeMy WebLinkAboutPlumbing (addn to #18767) CITY OF OSHKOSH N2 20780
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG tg SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS l 6 0 sC 4 PLAN NO.
/
DESIGNER GNER
USE /NATURE OF WORK F / e„2„..�� /g ?
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
- Lav Sh / DW DF San. Sewer
- WC FDr _L SP Ur Storm Sewer
- Sink L LTub Eject SS Water
Other
FEES: Valuation $ 3e - Q 0 Permit Fee Paid $ /oz • 0 — ✓ Park Dedication $
ISSUED BY C cC Date AVM �90 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNA -LeY /%_ ..,. ./_ , / a -/S - � -
/' / AGENT /OWNER DATE
ADDRESS // A ,A s ,.(y,,/ -{%' � 4 7:5 76",?C>
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS 14 OS - � R ..c v / e-� --Y- -� ,- ., DATE • °1 2- �j` PERMIT # - g 6
OWNER ( - zit-�� �4. -- PLUMBER /e_% f ��c —,....
NATURE OF WORK r ., - -.e y — L P,- ,�.a,,.,.e„�... # (/ / e 7
NEW RELAY REPAIR INTERIOR
SAN SEW # # WATER Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet / Sump Pump
INSPECTION DATE INSPECTION DATE Kit Sink Local Waste
Sink(other) Site Drain
Shower Laundry Stand pipe
Floor Drain / Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
41; i Urinals Future outlets
1 ** Violation notes on reverse side