HomeMy WebLinkAbout0021636-Plumbing (interior) CITY OF OSHKOSH N2 21636
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ikr SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ° ) •/ S r
PLAN NO.
OWNER 4 ' D �`
DESIGNER
USE /NATURE OF WORK o,_, S 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
BT ___1± WH F Disp WSoft CBasin
a Lav l` Sh I DW DF San. Sewer
WC I' FDr t SP Ur Storm Sewer
L Sink LTrrb i t c, Eject SS Water
Other
/
FEES: Valuation $ 3 tT6 - Permit Fee Paid $ --.44(eja' -5-61- O O Park Dedication $
ISSUED BY Date 11 / Final /O.P. 1 /73971/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE (7 -•4- • - "--r--,, I t 2 1 -
1 AGENT /OWNER DATE
ADDRESS
TELEPHONE #
/ PLUMBING PERMIT APPLICATION
ADDRESS , Y76 -S< DATE / / :/ /5 / 7 ,4) PERMIT # °' l 6 3;
OWNER 6- a.z.., 1J PLUMBER A_)azGfe-
NATURE OF WORK ti'.Q-w S /.:-
NEW RELAY REPAIR INTERIOR
SAN SEW i // #
WATER / Bathtub /' Catch Basin
STORM SEW 'A. Lavatory // Grease Trap
>-Toilet // / Sump Pump /
INSPECTION DATE INSPECTION DATE / Kit Sink / Local Waste
Sink(other) Site Drain
c ut.,6-cA.. C. -` „,2, w/ 4r- /0/ / Shower / / Laundry Stand pipe
j , � ,, �L�(� 3/13/7/ / Floor Drain // Laundry Tray
,,` j -3 v - 9�
1 Disposal Wat. Softner
/ Dishwasher / D. Fountain
/ Water Heater / Ejector
.� ,� 4 ,Z�, f roP Urinals Future outlets
4
1 ** Violation notes on reverse side A .A -4 - &� J 4 NS / " SS
£ -