HomeMy WebLinkAbout0031091-Plumbing CITY OF OSHKOSH N °_ 31091
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ] SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ? " `S PLAN NO.
OWNER
I 6 a--r--4
DESIGNER 4 USE /NATURE OF WORK 470`Z' /7 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 p Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR ✓ e�
BT _ WH _ Disp _ WSoft CBasin
Lav _ Sh _ DW _ DF _ San. Sewer
— WC _ FDr _ SP _ Ur Storm Sewer
- Sink _ LTub jest - SS Water
Other 1 C t
FEES: Valuation $ 3 O a , o a / .,cN d"
Permit Fee Paid $ Park Dedication $
ISSUED BY Date 9- 3 v- 9 L Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
C. ,I - " 3 3e, SIGNATURE Y0.- A` _ C�� , d 5C, . ,u. � g •- 30 `i Z_
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
�� PLUMBING PERMIT APPLICATION
ADDRESS
� DATE . 9/1/0) - MEM . 3 Y`
OWNER ' '. �� - . PLUMBER -6 ...-z......,2--
NATURE OP WORE dam- "C
NEW RELAY :4:4 -AIR INTERIOR
SAN SEW
WATER Bathtub #
r• :'. A, Sump Pump
Lavato E'ector
INSPECTION DATE INSPECTION DATE Water Softener
DATE lit. Sink Drinkin g Fountain
Sink(other) Urinal
' l
11 k '. / rf Waterheater Slop Sink
Shower Grease Trap
Floor Drain Local Waste
` Laundry Tub Site Drain
Disposal / Laundry Standpipe
Dishwasher Catch Basin
■
** Violation notes on the reverse side]