HomeMy WebLinkAbout0022158-Plumbing (pan washer) CITY OF OSHKOSH N2 22158
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ,4' SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS
/0 0 2 ."! 7177:5
PLAN NO.
(l ir_ OWNER
DESIGNER
/ 7
USE /NATURE OF WORK A ___ : /
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 El Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR --edr
BT WH Disp WSoft
CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS
Water
Other
FEES: Valuation $ /del °. 0 6 Permit Fee Paid $ / ° - 0 0 Park Dedication $
ISSUED BY ��J � --�Z c.4.� Date / ;/ Final /O.P. 1 2 ' I P
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE _. .' -
AGENTIOWNER
DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS /� $ DATE /..- PERMIT# ) . s
OWNER C ; & ' PLUMBER 0. - 6.-
NATURE OF WORK , Q
NEW LAY REPAIR INTERIOR
SAN SEW # :#
WATER I Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
0' il / - -// / Shower Laundry Stand Pipe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
t** Violation notes on the reverse side!