HomeMy WebLinkAboutPlumbing (interior) CITY OF OSHKOSH No 11509
C4 PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG a .. SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /6/ t/e-v/ i i PLAN NO.
OWNER K4 7<4/4
DESIGNER
USE /NATURE OF WORK '- - ,e ��_. I it Al, . ) Y .!� _ -
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 A4- 4—
BT i k WH / Disp WSoft CBasin
4 / At Lav i Sh DW DF San. Sewer
/
TO_ _ WC / FDr 4 SP Ur / Storm Sewer T /mss
1_ Sink LTub , _ Eject SS —Water
4-614/ p'
Other , / i /t.•
//743 + /n
FEES: Valuation $ /, Permit Fee Paid $ 6,2 -- I Park Dedication $
ISSUED BY Date / Final /O.P. 07" c� '-
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE C i P +.° 6 - ,12, /---(-- Ff
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
.La -, 5
/L� PLUMBING T APPLICATI /�
ADDRESS /6/4 / Vf `, �. DATE . 1 l PERMIT# JJ�G0
OWNER . / E k� j PLUMBER . 41 Ai . 2 (k e - 61 7--
NATURE OF WORK ��� ,./'
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
1 �� ( ' b Shower Laundry Stand Pipe
�, (/t/l Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
, Water Heater Ejector
_ Urinals Future outlets
I** Violation }cotes on the reverse side