HomeMy WebLinkAbout0028661-Plumbing (interior) CITY OF OSHKOSH N°_ 28661
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG1 SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS � �� ( N PLAN NO.
OWNER 6- t 1
DESIGNER
USE /NATURE OF WORK F ---e-- Q �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 •. - -
BT WH Disp WSoft CBasin
Lav Sh _L DW DF San. Sewer
WC FDr SP Ur Storm Sewer
' Sink _ LTub Eject SS Water
Other
FEES: Valuation $ S4 0 Permit Fee Paid $ 8 ' n Park Dedication $
ISSUED BY C'`14 Date V/ Y9 2 -- Final /O.P. 3 ' - < 2
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .4. Mph 5
1 AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PER1CT APPLICATION
LDDRESS f / '-'4'--) / `� - k 6
A �_ PERMIT#
PLUMBER c,,e;
NATURE of Won F
NEW BELAY REPAIR INTERIOR
_ I _
wA ; A = Bathtub #
Su.. Pu, ,.
Lava) // E'ector
� �, .l INSPECTION To11lt // Water Softener
DATE /lit. Sink Drinking Fountain
f _ / Sialc(oth�r )
Urinal
Waterheater Slop Sink
/ Shower / Grease Trap
Floor Drain Local Waste
Laundry Tub Site Drain
'Disposal Laundry Standpipe
Dishwasher / Catch Basin