HomeMy WebLinkAbout0005360-Plumbing (water heater) n CITY OF OSHKOSH N°_ 05360
`' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG� SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ��d ,�, c�i��/ Yi"✓4 PLAN NO.
OWNER �� ���z.e
DESIGNER
USE/NATURE OF WORK �u
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
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 $ � Park Dedication $
ISSUED BY � Date � —� � Final/O.P. ���0�1',7
In the performance of this work I agree to perform all work pursuant to rules governing the described const�uction.
SIGNATURE ��—���
T/OWNER DATE
ADDRESS
TELEPHONE#
PLUI�ING PERMIT APPLICATION
ADDRESS ��� DATE � 7 PEFMIT �� g�3 �n
OWNER ` PLUDZr3ER � G%
NATURE OF WORK �
NEW RELAY REPAIR INTERIOR
SAN SEW �� ��
WATER athtub Catch Basin
STORM SEW avato Grease Tra �
Toilet Sump Pum
N PE TION DATE INSPECTION DATE Kit Sink Local Waste
Sink(other) Site Drain
� �'��0 �� Shower Laundry tan pipe
Floor Drain Laundry Tray �
Disposal Wat. So tner
Dishwasher D. Fountain
a.ter Heater Ejector
Urinals Future outlets
' ** Violation notes on reverse side