Loading...
HomeMy WebLinkAboutPlumbing (storm lateral) � S� On CITY OF OSHKOSH N° tiLvv � PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG� SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS - - - - - - - -� S'C � ���Et'v�/�� - • - - - - � - • - - - - - - - - -PLAN NO- - - - - - - - • • - OWNER ` -.�- � �-c� / DESIGNER 1 /� USE/NATURE OF WORK ���'�� ���-z-- .�l� BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Foundation - Class of Const. Occupancy Permit , HEATING CONTRACTOR Neat ❑ 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 $ �n C'e •�-' �-' Permit Fee Paid $ '��`� �� � Park Dedication $ ISSUED BY f��� Date �� �� - � � Final/0.P. In the peAormance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE ���"�A� "`� � Z- S-7¢ AGENT'OWNER �ATE ADDRESS TELEPHONE♦ �.ta 2rxnC PEB2�2 AYPLIGTLON �C� 5 r� ?iDDBESS S 3�+2v ���_�� DATE ��r�(C' G;£ PEffiQT# OWNEH �-� . PLDl�*R , NA� 0 ilOBR � �� ��� � ��%-�-`/ NEi� RELAY REPAIR INTERZOH SAN SEA � # �JATER Bathtub Sum Pu %� f ✓ �� Lavato Ej ector TOilet Water Softener SPE ON DATE ZNSYECTIO��Nj DA� Rit. Sink Drinkin Fountain � � � ( �-� � /7 � Siak(a[her . �' T� W te heater Slo Sink G ease Tra S,�� lY/ /Z/9� Floor DrTun Local Waste , Laundry Site Drain Dis osal Laundr Stand i e Dishwasher y Catch Basin ** Violation notee on the rever�e eide