HomeMy WebLinkAboutPlumbing (addn to #21708) CITY OF OSHKOSH N°_ 24259
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / 6 / , PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK st c - / / l O
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ NC ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New p Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR _____,- ---gf-3-4 14--
BT WH Disp WSoft CBasin
Lav _ Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject . SS Water
Other lC�
V
Aoe,0
FEES: Valuation $ _ Permit Fee Paid $ /0, t d Park Dedication $
ISSUED BY Date 7 -74. — ?/ Final /O.P.
In the performance of this wo . gree to perform all work pursuant to rules governing the described construction.
—9/ SIGNATURE % / 7
AGENT /OWNER DATE
ADDRESS 4W757 576
TELE P
ONE #
PLUMBING PERMIT APPLICATION
ADDRESS � DATE 6.------2- 3 - 5V f 2 5-7 RMIT ��
OWNER Z /„' PLUMBER ��' `
NATURE OF WORK F - (- .- 9/ 70 8
NEW RELAY REPAIR INTERIOR
SAN SEW 1 # #
WATER Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit Sink Local Waste
F 5 -,, 3 _ Sink(other) Site Drain
Shower / Laundry Stand pipe
Floor Drain / Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
1 _Urinals Future outlets
1 ** Violation notes on reverse side