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Home My WebLink About0021547-Plumbing (cap for raze) � _ CITY OF OSHKOSH N°_ 21547 PERMIT APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG �SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - : ADDRESS '� � �� PLAN NO. OWNER �a-�� GtJ � DESIGNER � USE/NATURE OF WORK � �"�'"�'� � BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height a ' 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 —BT _WH _Disp —WSoft CBasin —Lav _Sh DW _DF —San. Sewer —WC _FDr _SP —Ur Storm Sewer —Sink LTub _Eject —SS Water Other FEES: Valuation $ ��`'� a Permit Fee Paid $ ��' e� U Park Dedication $ ISSUED BY_��1C / „ Date��/� Final/O.P. c In the performance of thi work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE ��'�' � ��'�_� AGENT/OWNER DATE . ADDRESS TELEPHONE# PLUMBING PERMIT APPLICATION ADDRE S S ��7 S-c a�:ti�-�.�-� DATE �'//>__ I v E RMI T�� -s^�� OWNER - �t �" P U1��R „��-� 1 � NATURE OF WORK �� %%� :o��'_-�cr-��--- �� NEW RE�.AY REPAIR INTERIOR SAN SEW �k �k WATER Bathtub Eatch Basin ORM SEW Lavator Grease Trap Toilet Sum Pum INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste O , ) � Sink(other) Site Drain �� -�( - �� Shower Laundry Stand Pipe Floor Drain Laundr Tra ; Dis osal Wat. Softner Dishwasher D. Fountain Water Heater Ejector rinals Future outlets ** Violation notes on the reverse side �