HomeMy WebLinkAbout0023413-Plumbing (addn to #21636) CITY OF OSHKOSH N° 23413
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG [ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 42- K/ C) p" 5 PLAN NO.
OWNER �� l' -
DESIGNER
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USE /NATURE OF WORK -
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-) eA__ = '
BT WH Disp WSoft CBasin �"V
Lav Sh DW DF San. Sewer
WC _L FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
/ FEES: Valuation $ / '- 6 ° Permit Fee Paid $ / c3 ` �� �'
` � Park Dedication $
ISSUED BY Date /
2 - ,'/ Final /O 0 r ?1''j(
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE - • rte -Z - '
AGENT/OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS ,V9d
-Cr- DATE s-_ /- 9/ PERMIT # 2 <2
OWNER 6 0 - LUMBER C,clG��
NATURE OF WORK tiu ,� _y,-- c - ,2 / 3 C
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER athtub Catch Basin
STORM SEW avatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit Sink Local Waste
F __C- 77 -9/ Sink(other) Site Drain
Shower Laundry Stand pipe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
r Urinals Future outlets
J ** Violation notes on reverse side :