HomeMy WebLinkAbout0041414-Plumbing (interior) ��d
CITY OF OSHKOSH N� 41414
� PERMIT - APPLI ATI N AND RE RD
C O CO
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT `
ADDRESS '���� /� � /'�°"/��^- PLAN NO.
OWNER
��.-._. I�J `
DESIGNER
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USE/NATURE OF WORK �'v �'���� • �
BUILDING CON7RACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
H�ATING 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
�li� _
�Lav _Sh _DW �DF —San. Sewer
vWC 3 FDr �SP �Ur _Storm Sewer
—Sink —LTub _Eject —SS —Water
Other �
FEES: Valuation $ �d��• � � Permit Fee Paid $ ��'� �' Park Dedication $
ISSUED BY f�J—� Date � �� � Final/O.P. -lE� '�-3`9�
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In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE �'� ���� � � � S°G X�3I I 9`/
AGENT/OWNER DATE
ADDRESS
TELEPHONE N
, �P1L�ZNC PEBMI? APPLICa?ION T �C'
�DDRESS .3 a/S- 2/• ' � ' �- � �
OWNEB - DATE � 3 �S ffiQT� `��5�/ S�
NATURE OF WOR� ��, �
I�I,T RELAY BEPAIR II�TTERIOR
t
SEf�T � # :
�JA1EA Bathtub / Sum Pu
I.svato Ej ector
Tailet Water Softener
�N DA� INSPECiZOl� � Rit. Si
Drinkin Fountain
Si.ak other
W te he ter Slo Sink
e se Tra
Floor Drain Local Waste
/ l � �i l � I Laundry Tu Site Drain _
��� ?5� Dis osal Laundr Stand i e
�� � c3/�_ � /L� /3 � �j" Dishwasher Catch Basin
� / J
� 1 �13a
;'�* Violation notes on tlis reverae �ide