HomeMy WebLinkAboutPlumbing (interior ) (4-) CITY OF OSHKOSH N2 09523
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG, SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 6 3 / - l [ / PLAN NO.
OWNER 7e-Z / ' ? C -4I
DESIGNER
USE /NATURE OF WORK f _ ter. r i ` , �1� . < : „0: '
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 iR-
BT ! WH 4 Disp WSoft CBasin
Lav Sh DW DF San. Sewer
a WC _4 FDr _4 SP Ur Storm Sewer
Sink _ LTub ject SS Water
Other - _ , i1 - _ i ■ . i -
/
o. L ✓
FEES: Valuation $ I ti - 31
Permit Fee Paid $ 0 Park Dedication $
ISSUED BY - Date Final /O.P. / - aly'F 9
In the performance of th'- work agr all work pursuant to rules governing the described construction.
SIGNATURFp<_
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
/(067 /� PLUMBING ERMIT APPLICATIN
ADDRESS ' - / e f'Ll1 / � DATE // ' / PERMIT# fs -Z 3
OWNER �r\-"-: f% r (C L�/
��r PLUMBER /�G G L
NATURE OF WORK /' (2iZ y 5-
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER -7 Catch Basin
STORM SEW Lavatory Grease Trap
,3 Toilet / Sump Pump
INSPECTION DATE INSPECTION DATE / Kit. Sink Local Waste
Sink(other) Site Drain
TJa �,A Shower / Laundry Stand Pipe
f /v`i , / Floor Drain Laundry Tray
Aft . / Disposal Wat. Softner
COI/1.1e e4/ / Dishwasher D. Fountain
_J Water Heater Ejector
Urinals Future outlets
,/sod
I** Violation notes on the reverse side]