HomeMy WebLinkAbout0038073-Plumbing (interior) CITY OF OSHKOSH N ° - 38073
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG j�] SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS � � ° _e_f
PLAN NO.
OWNER 6' • p
DESIGNER ,�J�
USE /NATURE OF WORK / Y -��� c
7 -
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 ,/,
I BT C WH Disp _ WSoft _ CBasin
Lav I Sh / DW DF San. Sewer
7— WC / FDr / SP Ur Storm Sewer
Sink LTub �L Eject ._. SS ._ Water
Other / - ECG f A,
FEES: Valuation $ 5 - 6 9' 2 - a 0 Permit Fee Paid $ s "� - C Q Park Dedication $
ISSUED BY �` Date °� � / Final /O.P. /P.110/9
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE c }....11 �q
AGENT /OWNER DATE
ADDRESS
•
TELEPHONE #
P L YING PERKS APPLICA ON 3567
ADDRESS, � s-- S/ DATE . 2 3 �- PERPaS#
OWNER , Il `---#.-'- L�/
NATURE or WORK .Si 'l -
1 RELAY REPAIR as •/: OR
ETA R e #
=Bathtub r p Su • L u II I•
KI '64 A, �'� E' ector
MI Toilet BEM= Water Softener
'1 0,_, • DATE INSPECTION • TE =Kit. Sink MIMI Drinkin• Fountain
' - MI Sink( other
l �� a S lo• Sink
e= _,6--- 9/40,e oI� ��/ e_se Tra•
i ioP2- ,fs o i,,1 EN Floor Drain / Local Waste
Laundry Tu• Site Drain
0. v Q ' _ W$ Dis•osal / ? Laundr Stand•i•e
F /;_/6/i 3 Dishwasher Catch Basin
4 gS ' / 3 '',l, J
** Violation notes on the reverse side(