HomeMy WebLinkAbout0012839-Plumbing (interior) CITY OF OSHKOSH No 1
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS � �` 3 / � '��Gt� PLAN NO.
OWNER 6 ,en ji_
DESIGNER
(7 USE /NATURE OF WORK ' _ - _ , - Z4.1 Gt i _ ' i 7,..d. r
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 L /(/ Q! =4.4..
BT rI WH L Disp WSoft CBasin
Z Lav — Sh ± DW DF San. Sewer
WC _L FDr SP Ur Storm Sewer
L Sink LTub Eject SS Water
Other /— 4 ° Zr ,/,01 (-
/6 -9
Cr FEES: Valuation $ sc52) Permit Fee Paid $ xy Park Dedication $
ISSUED BY 7r--� Zs -- •ti— / Date 1 - T - , Final /O.P. 1//- 7
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
/ PLUMBING PERMIT APPLICATION
ADDRESS, Z) , J �t�-r/'s /. DATE r�Z /9/ PERMIT# /#2. g 3 r
OWNER . ��/2JCC fry/ ' - ?
/v PLUMBER
NATURE OF WORK 4V P / S/''
NEW RELAY REPAIR INTERIOR
SAN SEW # _ #
WATER Bathtub U J Catch Basin
STORM SEW Lavatory q Grease Trap
Toilet 11 Swap Pump i
INSPECTION DATE INSPECTION DATE ICit. Sink 1 Local Waste
/� Z / So her) Site Drain
KI (F �/ t, e.��v / Shower Laundry Stand Pipe 41
i,1,C 3 !1 1si L'� .1 �
cevyT Ga (( Floor Drain Laundry Tray
Disposal ( Wat. Softner
y7 / �) / / Dishwasher j D. Fountain
.5- /0 !/ U' 1 �d P (ti``Q ��s� > Water Heater ( Ejector
2) 5 ce 1 1e Wlv Urinals Future outlets
% hiy
(** Violation notes. on the reverse side! f 7124