HomeMy WebLinkAboutPlumbing (addn to #9391) CITY OF OSHKOSH N2 11270
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG iz SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /c A/ PLAN NO.
OWNER iC/elf!' 7
DESIGNER
USE /NATURE OF WORK _.1 s. i _ / . i Iri / ' )e' / _
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 , 2/ "../T �G L- AL
BT WH Disp WSoft CBasin
2 —Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
V
FEES: Valuation $ / Permit Fee Paid $ / Park Dedication $
ISSUED BY i'Ir Date `l Final /O.P. /. A rg
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
' a444-
AGENT/OWNER DATE
ADDRESS
TELEPHONE #
ADDRESS >C� �/ � � , Y
PLING PERMIT APPLICA ON/ / O
DATE . 7 .3 6 PERMIT# /l
OWNER 47t,--1.4 � ( PLUMBER .,14
NATURE OF WORK 4. JIN G� . l-Ii.. 4,, Td' l o.,,f.,4 1 4 g' D 9j 9/
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER I Bathtub Catch Basin
STORM SEW! Lavatory Grease Trap
Toilet III1Sump 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
Urinals _ Future outlets
j** Violation, notes on the reversesidej