HomeMy WebLinkAbout0027454-Plumbing CITY OF OSHKOSH N2 27454
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS `,e) / S PLAN NO.
OWNER / 0
DESIGNER ! fi USE /NATURE OF WORK 4 --
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 WH Disp WSoft CBasin
/ Lav _ Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ / ° 0 ° • ° a Permit Fee Paid $ At 0 - Ca m Park Dedication $
ISSUED BY C..-3 Date ¢ — ' 4 ,4* _9 2 -- Final /O.P. 3-- 5 9 0?
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ��v� Z — 0 - ? . e_
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUM RING PEBbIT APPLICATION 7 �s
riDDRESS d �° 9 s DATE . _ ° 9 — pE31 # -
NATURE OF WORE " - _ _
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER Bathtub Sump Pump
STORM SEW Lavatory / Ei ec tor
1 Toilet Water Softener
INSPECTIOi� DATL INSPECTION DATE Kit. Sink , Drinking Fountain
I(&-- .. — Sink(other) urinal
2 Waterheater Slop Sink
i (7L-) �: Shower Grease Tran
Floor Drain Local Waste
Laundry Tub Site Drain
3 - Disposal Laundry Standpipe
Dishwasher Catch Basin
** Violation notes on the reverse side(