HomeMy WebLinkAbout0019775-Plumbing CITY OF OSHKOSH N° 19775
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG Al SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ' ,Z9/ PLAN NO.
OWNER ilta I'L r , '
DESIGNER O �J
USE /NATURE OF WORK . �C
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 if;fro.e).),
BT WH Disp WSoft CBasin
Lav / Sh DW DF San. Sewer
--L- WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ / 24/ o • 0 c 4/ Permit Fee Paid $ /at -
Park Dedication $
ISSUED BY Date �-- 3 '-1a Final /O.P. -/ ! /
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE _� n /�
K W /� ✓ /vt� u atd�Ol�l'� ' /7 o, 8 • f -9d
I/ AGENT /OWNER J DATE
ADDRESS /
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS Z : / : p
�� G�% / 14 ..�r�vr a� DATE .r - Jr / - `?' PE RMI T f / / 7 ?
OWNE R �i� D PLUMBER iV'7
NATURE OF WORK 8 ..15 7 /e/
NEW RELAY REPAIR INTERIOR
SAN SEW
# #
WATER Bathtub Catch Basin
STORM SEW Lavato 7 V Grease Trap
/ Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink
Local Waste
A21: 0 1 3-, Sink(other) Site Drain
`
/ Shower Laundry Stand Pipe
Floor Drain Laundry Tray
1-- s-/-.2 Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
t** Violation notes on the reverse side!