HomeMy WebLinkAbout0017062-Plumbing (interior) CITY OF OSHKOSH N2 17062
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG, SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ,eV e' ,1,/, /C %.-ra.- �t PLAN NO.
OWNER l"�;: rite-I 04 %e <
DESIGNER
USE /NATURE OF WORK e-(-c/ .S' /"ls / / r �. v - i' - S
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 Z....-e% L / S
BT WH _k Disp WSoft CBasin
Lav Sh _4 DW DF San. Sewer
s_ WC FDr j_ SP Ur Storm Sewer
1_ Sink LTtrb. Eject SS Water
Other
/‘ /
F
/
EES: Valuation $ 7 z Permit Fee Paid $ ( Park Dedication $
ISSUED BY Date / - .2.2 ---PQ _ Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE pC ea_ W 4.5bL GI, i_28-
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS ....45 "74, /
G ' DATE L0
OWNER • -�..
- PERMIT # /
,
NATURE OF WORK - PLUMBER /er
S
RELAY NEW
SAN SEW -® RIOR
WATER
STORM Si E =-- -rathtub
- -� avato cr Basin
N P CTION Grease Tra.
DATE INSPECTION
111111 Sump Pum.
/ / . / DATE
i� 1/' (� - U -r-e) •Sink(other) _ Local Waste
Shower III Site Drain
_
Floor Drain Laundry tan. pipe
i000sl _ Laundry Tray
Iii Dishwasher _ Wat. So tner
END. Fountain
- Ejector'
- Future outlets
** Violation notes on reverse side