HomeMy WebLinkAbout0035763-Plumbing (interior) No 35763
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBGf SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / / d G LA/ PLAN NO.
OWNER r- V
DESIGNER
USE /NATURE OF WORK /is ye R. i
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 `G�- ZZ2:
i BT ___L WH Disp WSoft CBasin
?` Lav 1 Sh DW DF San. Sewer
_ WC 1_ FDr SP Ur Storm Sewer
Sink LTub Eject — SS Water
Other i — 4 C
FEES: Valuation $ ?`" 0 0. 06 Permit Fee Paid $ , S - 0 2 d Park Dedication $
ISSUED BY Date 9///72 Final /O.P. 7/ •0 '93
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 9 - I t
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
K-0
PLUMBING PERMIT APPLICATION
ADDRESS, gO o % � - L ti' DATE , ® / F 3 PERMIT# '�7C,
OWNER G' Q � PLUMBER ems''
NATURE OF WORT ,S t .k ' r.4
NEW RELAY REPAIR INTERIOR
,AAN SEW # #
WATER / Bathtub 1 Sum. Pu
STORM SEW Lavatory Ejector
2 Toilet // Water Softener
INSP ECTION D ATE INSPECTION DATE / tit. Sink / Drinking Fountain
/ / s /J7j l jDO°� Sink(other) Urinal
f �r C.� / � / 0o'\ , / Waterheater / Slop Sink
1 Shower 1 Grease Trap
°'� / Floor Drain / , Local Waste
:Laun Tub
Y Site Drain
F I I J, / �3 , / Disposal 1 / Laundry Standpipe /
/ ( / Dis wa here / Catch Basin
Pigl_
** Violation notes on the reverse side{
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