HomeMy WebLinkAbout0021269-Plumbing (new 1/2 bath) /� CITY OF OSHKOSH N°_ 21269
�' PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG � SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS f ' N��' Y PLAN NO.
OWNER � • � ����-al-�
DESIGNER
USE/NATURE OF WORK ��–� f�� �
BUILDING CON7RACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Y Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fi�ures 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 $ �G� •G G Permit Fee Paid $ �v • O O Park Dedication $
ISSUED BY �,� Date Cd/'L�/�� Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER AT :
ADDRESS
TELEPHONE;f` �
PLUMBING PERMIT APPLICATION
ADDRESS � /� - /���''- ' 1 %" DATE S �� `� PERMIT�k ����,� ;
OWNER � � ,����??��_� PLUI��R /7G��.rz 3'c'�._
NATURE OF WORK �, .<�u �
,
NEW RELAY REPAIR INTERIOR
SAN SEW 46 ��
WATER Bathtub Catch Basin
EW Lavatpr Grease Trap
' Toilet Sum Pum
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
Shower Laundry Stand Pipe
Floor Drain Laundr Tra
Dis osal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
inals Future outlets
** Violation notes on the reverse side
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