HomeMy WebLinkAbout0011858-Plumbing (replace fixtures) CITY OF OSHKOSH
N2 1
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / (..,?‘ ,/ / J e 6, PLAN NO.
OWNER /, � lS
DESIGNER
USE /NATURE OF WORK
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 . Jive i &
BT WH Disp WSoft CBasin
- Lav Sh DW DF San. Sewer
- WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other . r �?iyLJ
� o�
FEES: Valuation 7,$ �vv rmit Fee Paid $ Park Dedication $
ISSUED BY r <JY Q�-
Date / -2— •• -7--- at Z . Final /O.P../c - ;27 - 2 /il
In the performance of this w k I agree tperform all work pursuant to rules governing the described construction.
SIGNATURE °L
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
Q ,7 C. / PLUMBING PERMIT APPLICATION
ADDRESS /�
i 77//YI (v ii 4, DATE l0 d . P: : I T# � PLUMB — �_� Ay/ /
OWNER P.,-'r�l i s _ � � i
NATURE OF WORK ��
NEW RELAY REPAIR INTERIOR
SAN S Bathtub Catch Basin
STORM SEW Lavato • Grease Tra.
S Toilet S P
Local Waste
INSPECTION DATE INSPECTION DATE / Kit. Sink Site Drain
Shoowweer r /
Sink(other) Laundry Stand Pipe
Floor Drain Laundry Tray
/;--2-7 Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
P** Violation notes on the reverse side'