HomeMy WebLinkAbout0025773-Plumbing 4.) _CITY OF OSHKOSH N9 25773
PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG yJ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS °2101-0 "'/ PLAN NO.
OWNER .J
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DESIGNER
USE /NATURE OF WORK. 7P4 .ACT J r'..-fs;"--'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 I
BT WH Disp WSoft CBasin C.J,4_
J. Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
Z=EES: Valuation $ / d ` 0 a y Permit Fee Paid $ / ' o a r Park Dedication $
ISSUED BY Date /o -/S---- "/ Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE / 0 `/c — 9/
AGENT /OWNER DATE
ADDRESS / yO oZ Sir 'A G e ...c r ) 3-‘7q7
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS 07 / / 7_Pir u. DATE /=='' - { 7 7 PERMIT# . ' 74-773
OWNER ` e5- -z PLUMBER
NATURE OF WORK Agra ..�G� -,,, r-
NEW RELAY REPAIR INTERIOR
SAN SEW I # #
WATER I Bathtub Catch Basin
STORM SEW! / Lavatory Grease Trap
/ Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
RI— � 6 Sink(other) Site Drain
Shower Laundry Stand Pipe
Nf7 H j Floor Drain Laundry Tray
"� g - 9-L. Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
, Urinals Future outlets
v ?J/-
f** Violation notes on the reverse side'