HomeMy WebLinkAbout0028341-Plumbing CITY OF OSHKOSH N° 28341
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG, SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / ..00 i 4,.�
�-^ .A PLAN NO.
OWNER J
/
DESIGNER
USE /NATURE OF WORK - -7-"-e -ele-
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 A / .P -y p v� -
BT 3 WH U Disp WSoft CBasin
1
4.;);te___
Lav _ Sh DW yDF San. Sewer
WC FDr SP Ur Storm Sewer
12 Sink _ LTub Ej t SS Water
Other 3 - cy.e..,,,_
/g < 7,2_
FEES: Valuation $ ' T> -S 00, Permit Fee Paid $ 7-0'1' 0 d Park Dedication $
ISSUED BY C.,Q Date S //7`' y
Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ( ti 4 i t , C.{., .-Z.r _. t e , / c-, 7 �� A WNER/
dd 1 'DATE
ADDRESS le) d / 72 Z L - G S f , 7 L- - L _( / ' c/ 7- i 6 t-/) ,`
!' 0 { +", z 0 TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS, /3c o Lf o-e- WIN DATE z / '/ ' '-- PEBCT# °? ? 3 S/
OWNER . .2‹ PLUMBER , /(571----- Y- H
NATURE OF WORE , s �,-� P/
NEW REPAIR PRIOR _AmAx
SAN SEW # #
.WATER Bathtub Sump Pump
• ;,Y A. Lavat- Vector
Toilet Water Softener
•1 4 *le •h Diu INSPECTION DATE tit. Sink , Drinking Fountain
& Sink(other) t al
Mr STS 57k, Waterheater Slop Sink
Ad l t- , C ..-� �--e-) , :5 Shower Grease Tram
Floor Drain Local Waste
9/ Laundry Tub .2r Site Drain
Disposal Laundry Standpipe
,Dishwasher Catch Basin
** Violation notes on the reverse side(