HomeMy WebLinkAbout11503-Plumbing (interior) C4--) CITY OF OSHKOSH N o 1 1503
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS -2• . 1 i / . -14 PLAN NO.
OWNER _ e ice_ , ._ ; -
DESIGNER
USE /NATURE OF WORK f/ _ : --- ''
/
Iv
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ NC ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR M47 10 .
3 BT / WH Disp WSoft _ CBasin
Lav _ Sh j_ DW DF San. Sewer
3 WC __/.. FDr SP _ Ur _ Storm Sewer
1_ Sink _ LTub _ Eject SS Water
Other 4 .
/5- T`3
FEES: Valuat $ l � 7, 0 f�-
�;v Permit Fee Paid $ _ Park Dedication $
ISSUED BY cLr=7___ Date /°2/�4 Final /O.P. .
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE �� . / � C n ( _ _ /d ' /-if
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
1 ol)crrt 01470(
��� �( ���� �l'/1.�" PERMI APPLICATION ' /
� DATE `7 /
ADDRESS y PERMITVf /75
OWNER 1- e — % 1 ' ,e57ii--■ PLUMBER Z�/'J rA/ c
NATURE OF WORK 4/64,) ..S /m'
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER Bathtub /" Catch Basin
STORM SEW Lavatory l t Grease Trap
Toilet "r I Sump Pump J
INSPECTION DATE INSPECTION DATE Kit. Sink j Local Waste
G ��tf Sink(other) Site Drain
o w Shower g Laundry Stand Pipe
/ Floor Drain Laundry Tray l
/04 OCC °4- Disposal 1 Wat. Softner
Dishwasher D. Fountain
/ �1 Water Heater / Ejector
) �,� / /j7�J /P � Urinals Future outlets
il Violation notes on the reverse side] 04 I / / 77 -G
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