HomeMy WebLinkAbout0017063-Plumbing (interior) CITY OF OSHKOSH N2 17063
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG jg SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS o2 E i� (10 -/ - 'z' PLAN NO.
OWNER G� et. t. - d ‘f-e-tre
DESIGNER
USE /NATURE OF WORK - - t fj
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 -- #e-
BT WH Disp WSoft CBasin
Lav Sh 4_ DW DF San. Sewer
- WC I_ FDr SP Ur Storm Sewer
Sink 4 LT1b Eject SS Water
Other
FEES: Valuation $ 7 2-01 ) ....e. Permit Fee Paid $ b y Park Dedication $
ISSUED BY co'a-Y Date / — .2.2- FQ Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE C 02z
� r
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMING PERMIT APPLICATION `
ADDRESS 2 ?.z / /14/(7)171C/41^ e DATE /0 - /6 - P7 PERMIT # ( 7 d 0
(
OWNER 'r' 4 is-c 4 PLUMBER (i� rc✓ s
f/ TT
//
NATURE OF WORK /v�Aq SF
NEW RELAY REPAIR INTERIOR
SAN SEW i # #
WATER Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit Sink Local Waste
Sink(other) Site Drain
/// Shower Laundry Stand pipe
Floor Drain Laundry Tray
(A.,6 1/36(90 Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector'
Urinals Future outlets
** Violation notes on reverse side