HomeMy WebLinkAboutPlumbing (interior) CITY OF OSHKOSH N2 10035
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / O v A .4-Z? C�� PLAN NO.
OWNER 1/ eiS"- 422 1-1 C-
DESIGNER
USE /NATURE OF WORK �.-c J ` Sr idiQl Z yz
4
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 A ga-tr /
0 2., BT 4_ WH t Disp WSoft CBasin
Lav I_ Sh ÷ DW DF San. Sewer
WC FDr .,L SP Ur Storm Sewer
Sink LT b Eject SS Water
Other --
FEES: Valuation $ Mw Permit Fee Paid $ 1.2_- Park Dedication $
ISSUED BY Date Itr/‘d Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE fx -* * CitJ 4 � o _ (5
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
/`/ PLUMB APPLICATION
ADDRESS / b 7` / //P ` L?�t <l! i� f�' - DATE ��- PERMIT# /1 3r
I
OWNER L/ el" ( s-en \ t l� l4t' / PLUMBER a4 /
NATURE OF WORK /M.44/ . S'P
NEW RELAY REPAIR INTERIOR
SAL SEW # #
WAR 2 Bathtub " Catch Basin
STORM SEW 2 Lavatory /// Grease Trap
2 Toilet in / Sump Pump I
INSPECTION DATE INSPECTION DATE / Kit. Sink j Local Wastd
// Sink(other) Site Drain
a c5,48/ //01610/OY� ' / Shower I / Laundry Stand Pipe
/1a 1 / Floor Drain 1 Laundry Tray
1 Disposal 1 Wat. Softner
6 1 v � xN ' Dishwasher D. Fountain
//Si � c , j. Water Heater 1 Ejector
U L13-/1-.-----, Future outlets
,T V *ill r
i<.' ‘74264e f 1/44 1 bak i2.. i L (, et,
(** Violation notes on the reverse sidet w LA'A$r. �w.w
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