HomeMy WebLinkAbout0022505-Plumbing (relocate toilet & lav) � _ CITY OF OSHKOSH N° 22505
PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG�SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ��� � � ��� PLAN NO.
OWNER �C
DESIGNER �
� GJ �- ..��
USE/NATURE OF WORK � �'-'— G
BUILDING CONI'RACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
►
HEATdNG 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 $ � � ��' � Permit Fee Paid $ ��� �� Q Park Dedication $
ISSUED BY � ������""`a Date � � g Final/O.P.S/y ��/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE � � ��/ ��
AGENT/OWNER DATE
ADDRESS
TELEPHONE#
��PLiJIrBING PERMIT APPLICATION
ADDRESS �/'C3 � DATE 3 � i/ PERMIT�� ���'tS,S-�
OWNER -Sp L•_ - PLUI�� � r �- :.-..,
NATURE OF WORK 4� �' � rE�-z�—
NEW RELAY REPAIR INTERIOR
SAN SEW �� �k
WATER Bathtub Catch Basin
S� / Lavator
Grease Trap
/ Toilet Sum Pum
INSPECTION DATE ZNSPECTION DATE Kit. Sink Local Waste
�-�' �$J ¢`�`�) �/�/�� Showerther) Site Drain
Laundry Stand Pipe
� Floor Drain Laund Tra
s ' � �� Dis osal
Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
inals Future outlets
** Violation notes on the reverse side �