HomeMy WebLinkAboutPlumbing (addn to #8982) CITY OF OSHKOSH No 11168
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /G3 ,e vel «/ / PLAN NO.
OWNER I4 dj7..i/Y1
DESIGNER ,,L
USE /NATURE OF WORK 1. )/L ///.1 /I.,/ l / ` / /63-4 /Y!/ 1 * •F
A X-cf - t- 4/4-P-L -'7 tA../e0 / fr- v 1 ,
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 IPA/
BT WH Disp / WSoft CBasin
- Lav Sh DW DF San. Sewer
4 WC FDr SP Ur Storm Sewer
- Sink LTub Eject SS Water
Other
A-h ‘..)
FEES: Valuation $ 7 Permit Fee Paid $ S
Q() Park Dedication $
ISSUED BY -1 /�7 / Date �l Final /O.P. /0 2J — ere
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE _ .— ..c. •
A /OWNER DATE
ADDRESS
TELEPHONE #
ADDRESS ( D J b <47 ATEp /07,4V/ PERMIT# If la
OWNER 4 : 4v'dZ-A/ ------ PLUMBER �S' F /,�,L�rS4lL C
NATURE OF WORK t ai & -A Gt�c�4�[ < 7`� , .74.1 / Pig /-K i of uQ l
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER Bathtub Catch Basin
STORM SEW! Lavatory Grease Trap
L. / Y oilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
�/� ‘jG� vc 1 - Shower Laundry Stand Pipe
t/' ✓�" Floor Drain Laundry Tray
Disposal Wat. Softner
/o -- ?- -e – c Dishwasher D. Fountain
l Water Heater Ejector
_ Urinals Future outlets
i Violation_ notes on the reverse side{