HomeMy WebLinkAbout0019626-Plumbing CITY OF OSHKOSH N°_ 19626
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS go N\ ' V AA I A J �A� PLAN NO.
OWNER (L \c-- 1M c _ ik ✓ Lel
DESIGNER
USE /NATURE OF WORK , i -'0..)v w ` t` -ZYll`t V+ I- .
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 1. C-• M. .x\ `-4-- / i.3
JT BT _ WH Disp WSoft CBasin
SiK Lav Sh DW DF San. Sewer
4 CWC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
/
FEES: Valuation $ 247 c", t- '' Permit Fee Paid $ / 2' Z. u 0'6 � Park Dedication $
ISSUED BY (Gil 6 r---€ 64 -' Date 7 /° 1 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE r ♦ `i. . .— -A `) Z s 0
1 AGENT /OWNER DAT
ADDRESS .Vv tt tA) l 1 Z t L- 146 23 cam- I, O V
TELEPHONE #
'J,� PLUMBING PERMIT APPLICATION C� /��
ADDRESS Fv3 I ` — DATE // --- g/ — � PE T# / �O
OWNER M' A f / . n, � `
PLUMBER /7c /' vCe t�Yl
NATURE OF WORK � , „r Q. 1 .. e
NEW RELAY REPAIR INTERIOR
SAN SEW ., # #
WATER (( L Bathtub Catch Basin
STORM SEWI /.Lavatory j Grease Trap
Toilet I Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
Shower Laundry Stand Pipe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
_Urinals Future outlets
j** Violation notes on the reverse sidel