HomeMy WebLinkAbout0043590-Plumbing CITY OF OSHKOSH
N2 43590
PERMIT -� APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG (J SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 3 4� S �-- PLAN NO.
OWNER .�z
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DESIGNER /
USE/NATURE OF WORK Air..--A - / , �C1. t i /- 7. �2=. c
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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 — G —
— BT 4- WH _ Disp — WSoft _ CBasin
_ Lail _ Sh _ DW _. DF —. San. Sewer
— WC __t_ FDr _ SP _ Ur ._ Storm Sewer
— Sink L ub / _ Eject SS _ Water
Oth er - d, Al z °L' - - .t_ ■•'..L__________Fi ... C- ''
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FEES: Valuation $ 3 ° . c: d Permit Fee Paid $ (9 ` ` Park Dedication $
ISSUED BY , —/— Date I 7.S
Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 064 `" L 'el ? K." / — �� — 9 S'
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION y y=
ADDRESS 4.5" /�7oa -A2--1--' - • PERPIIT# _ K;
OWNER , .Q - .wrlar.■./ - p t .I:
t
RE
NATURE OF won_ ` '_ et.g, - -
/
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER i Bathtub Sump Pump
STORM SEW_ Lavatory Ejector
Toilet Water Softener
INSPECTION DATE INSPECTION DATE Kit. Sink Drinking Fountain
Sink(other) Urinal
11( (' 1 Waterheater / Slop Sink
,Shower Grease Trap
' Floor Drain / Local Waste
R
4 Soy Laundry Tub 1 Site Drain N
r� cj 5 SJ 3 Disposal Laundry Standpipe
Dishwasher Catch Basin
7 4 EYL.- 0450 i
', +AI' 9 -Z -
** Violation notes on the reverse side] V o w / -- /-