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HomeMy WebLinkAbout0035553-Plumbing (correct violations) N2 35553 CITY OF OSHKOSH PERMIT — APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG V SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS a - / PLAN NO. OWNER I \ Cr DESIGNER USE /NATURE OF WORK © Ln — f 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 CLECTRIC 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 L 4 C A) _Eject SS Water Other 2 e / FEES: Valuation $ O . O o Permit Fee Paid $ / C1 • 0 � Park Dedication $ ISSUED BY Date g /f3 Final /O.P. R,�` 1.3 In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE i �j i �i AGENT /OWNER D E ��'��' � ADDRESS (T/ v ��.t'b0 c� �//_ r _ � / '.$/' TELEPHONE # STATE OF WISCONSIN ) ) SS WINNEBAGO COUNTY ) /g6 e 44.5 , 33/ e $ _ (Na Addres being first duly sworn on oath deposes and says that he is not a licensed plumber, and that he has applied for a plumbing permit to the Plumbing Inspector of the City of Oshkosh, to do plumbing work in a home owned and occupied by him, or a home that is being constructed that is owned by him, and which will be occupied by him as his home when completed. That he is not building said home.for the purpose of sale. This affidavit is made for the purpose of complying with the provisions of the plumbing code of the City of Oshkosh and the State of Wisconsin, which provides that all plumbing work must be done by a licensed plumber except that the plumbing work may be done by one who owns and occupies his own home providing the installation complies with the plumbing code of the City of Oshkosh and the State of Wisconsin. This affiant understands that the Plumbing work authorized • by the permit applied for, must be done only by this affiant and that he cannot employ others who are not licensed plumbers to assist with the work. Dated this , t ? day of Are.S . 19 )2,..� Z., --_,- , ., 40 Subscribed and sworn to before me this /Y day of 41.; ,wad , 19,?3 . Notary blic, Winnebago County, Wisconsin My Commission Expires: 2.1.--ycs, 2 l99F, PLUMBING PERMIT APPLICATION ADDRESS / DATE V/ /y 3 PERMIT# , .?Ss'S" s' OWNER NATURE OF WORK 0/4.00,-&-L-0 ,o -. NEW RELAY REPAIR INTERIOR SEW # # WATER Bathtub Sump Pump %TORN SEW. Lavatory Ejector Toilet — Water Softener INSPECTION DAZE INSPECTION DATE Kit. Sink Drinking Fountain �� Sink(other) fr71 W aterheater Slop Sink ,Shower Grease Trap Floor Drain Local Waste Laundry Tub Site Drain Disposal / Laundry Standpipe - Dishwasher Catch Basin ** Violation notes on the reverse side