HomeMy WebLinkAbout0038104-Plumbing �-i G,
CITY OF OSHKOSH N°- 38104
n PERMIT - APPLICATION AND RE R
CO D
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG� SiGN ❑ ZONIN FLOOD PLAIN HEIGHT '
� - - - -
� � /10 ..�.�c� �
ADDRESS PLAN NO.
OWNER �
DESIGNER
� � n �
USE/NATURE OF WORK � ° � --G�zr
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
s
Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S
r
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
t BT _WH — isp —WSoft _CBasin G� :
�Lav —Sh _DW _DF —San. Sewer
�WC _FDr �SP —Ur —Storm Sewer
�Sink _LTub _Eject —SS —Water
Other
FEES: Valuation $ � 6� � � � Permit Fee Paid $ �""�-C � � Park Dedication $
ISSUED BY Date �`� � Final/O.P. �,2 -��"9�
In the pertormance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE `'�; ��� � �z-F I
AGENT/OWNER DA E
�-�
ADDRESS �� �°�'�S S r' 23S—�(rf �Q
TELEPHONE�_
�lc_,
�ZI�G PERI�? APPLIC.'�1ZON
anaagss 9'/8 � ��� � �� 30 �� �xraz� 3 �S�o S�
OWNEB p �-
NATQRE OF WOR� �Z 'v�
NE[1 RELAY BEP R OB
SAN SEW � * �
�A1ER Bathtub !
� Sum Pu �
Lavato / / Ej ector
Toilet Water Softener `
' �� �� INSPE�'1'IOIQ DA� Rit. Sink Drinkin Fountain f
Siak(other . '
'�Q � /�-// �33 �j � 3 � W te heater Slo Sink
� G e se Tra
!j Floor Drain Local Waste
� � /� Laundry Tu Site Drain
Dis osal Laundr Stand i e
� a J (�/ p �/ Dishwasher Catch Basin
` a lT
** Viols*;�.+ ww��� on tti rever� side