HomeMy WebLinkAbout016276 - Plumbing (remodel bath) CITY OF OSHKOSH N2 16276
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG 5e,, SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 15-32 / /7E i'-' //6r2,. -.. PLAN NO.
OWNER L— - /3C-(,,?-2N C-1 ll,,
DESIGNER
USE/NATURE OF WORK t"—B-? ric.r
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 :J `?, /i 4 74,'--A-3't !/jib
T BT WH Disp WSoft CBasin
Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
f✓a
FEES: Valuation $_ .2. Permit Fee Paid $ �'
� ��--.--.�.-�-- /2 Park Dedication $
ISSUED BY Date // — e- 1-1 Final/O.P. 7C-V-2 f/y
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 7;14 i647-101- -, Ai Pc /O4/ �l /197414/: /1 ' Y /
��// AGENT/OWN DATE
ADDRESS
TELEPHONE#
1 ��lo J Q PLUMBING PERMIT APPLICATION ,�
e /_ �' RMI T �k G
_`) 3 / tom... ✓ DATE
ADDRESS . L;L2 , �G Le
L/ u C✓'e . I L.,' ti i PLUMBER
OWNER ;
NATURE OF WORK ✓ ' ` .
INTERIOR
NEW RELAY REPAIR I# #SAN SEW Bathtub Catch Basin
STORM Lavator Grease Tram
STORM SEW 1 Toilet Sump Pump
Local Waste
NSPECTION DATE INSPECTION DATE Kit Sink Local
Drain
Sink(other) Site
Shower Laundry tangy pipe
/07,,,o/s., ! '` Aw` Floor Drain Laundry Tray
Disposal Wat. So tner
Dishwasher D. Fountain
/ /?3 / 0 .,/ , / I_ Water Heater Ejector
Urinals Future outlets
-2) 4r i ,,c ,..,', akric,..._ /9(9 7,,,t/,<e 05 27-5' 14/1 414,r ill '
** Violation notes on reverse side