HomeMy WebLinkAbout00026498-Plumbing (water heater) /� CITY OF OSHKOSH N°_ 26498
�' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG� SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ��`� Z 1�'� �^- PLAN NO.
� � F
OWNER �-�--�' �-
DESIGNER
USE/NATURE OF WORK � �� C� �
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
4
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 $ o� ° ° �� � Park Dedication $
ISSUED BY � `����`�-' Date � '�" ` � '_ `� / Final/O.P. '
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
� /
� ,--�
SIGNATURE i �Y'`- r �-(./� ,/,�� �r) .J , .�3U �r� -J ' �/
AGENT/OWNER DATE -
ADDRESS
TELEPHONE#
PLUrIDING PERMIT APPLICATION
ADDRESS /S—;,�-� DATE � �- ' G ' �'/'/ ,PERMIT�� � � ����
OWNER � ���-E-� � - PLUI�ER ��-�--�
NATURE OF WORR -r� G�1�
NEf+l RELA REPAIR INTERIOR
SAN SEW � �
WATER Bathtub Catch Basin
Lavato Grease Tra
Toilet I S P
NSPECTION DATE INSPECTION DA1E Rit. Siak Local Waste
Sink other Site Drain
�Q � � � — � Showez Laundry Stand Pipe
Floor Drain Laund Tra
Dis vsal Wat. Softner
,
Dishwasher D. Fountain
Water Heater E�ector
' Future outlets
.
** n' o the reverse side