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HomeMy WebLinkAbout0021147-Plumbing (remodel bathroom) � CITY OF OSHKOSH N°_ 21147 `' PERNlIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG � SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS y�'�' r '� ' �,'`' ° PLAN NO. OWNER `��''" f DESIGNER l USE/NATURE OF WORK ��L`'-z L-r°�T-�t'e �=��;. �LA BUILDING CON7�RACTOR 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 �lectric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR C�° _.�BT _WH —Disp —WSoft —CBasin � _�Lav _Sh DW DF —San. Sewer �WC FDr SP Ur Storm Sewer _—Sink LTub —Eject SS Water Other � 7 � az- G�3 FEES: Valuation $�-�L.���tt Permit Fee Paid $ �� -� Park Dedication $ ISSUED BY �''-�C�-x'�a�'� Date ��"--�� � r-�(`i FinaVO.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. �.� f / � . SIGNATURE�//d-�/rCe'-r.%E�'✓ �'{ �FJ'�.G`%/E� /����`��YC V AGENT/OWNER � DATE ADDRESS TELEPHONE# � PLUMBING PERMIT APPLICATION ADDRESS �aSS' �?��2-�G � .e DATE /C - a� - /�' v PERMj�T�� °?I�'��_ OWNER PLUMB�R /�I !" ��. '`�/�i I3ATURE OF IdORK �.� ��,s.�� � NE[+1 RELAY REPAIR INTERIOR SAN SEW �� �E WAT'ER J Bathtub Catch Basin TORM SEW / Lavator -- Grease Trap Toilet Sum Pum INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste � � �� � � � -� _ ,�� Sink(other) Site Drain Shower Laundry Stand Pipe Floor Drain Laundry Tray Dis osal Wat. Softner Dishwasher D. Fountain Water Heater Ejector rinals Future outlets � ��/� �� � � � �� Violation notes on the reverse side