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HomeMy WebLinkAbout0036938-Plumbing (laterals) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD N~ y"CJ / 36938 TYPE: BLDG 0 HTG 0 ELEC 0 PLBG)t1 SIGN 0 ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - -- - - - - - - - OWNER 30:?S- ~f~ S~~~ PLAN NO. ADDRESS DESIGNER )/srI< - @~~___ USE/NATURE OF WORK BUILDING CONTRACTOR Size Foundation Sq. Ft. # Rooms # Stories Height Occupancy Permit Class of Const. M- HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR Electric Servo New 0 Change 0 Temp 0 Type _ Volts _ Amps_ Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR Fo--r< ~~ E~ _BT _WH _ WSoft _ CBasin ~ _Lav _Sh _DW _DF -L San. Sewer V tv c _WC _FDr _SP _Ur ~ Storm Sewer '-f Pu C _Sink _ L Tub _ Eject _SS ~ Water I Cr-.- Other FEES: Valuation $ 7 so . <:> 0 ~ Permit Fee Paid $ Date / V'" S '0 . 0 c 11//.-r/7S / I Park Dedication $ Final/O.P. ISSUED BY In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE G1/J1~ . T/OWNER J~5/t3 . DATE ADDRESS TELEPHONE # .,.:" '.4- l'Lmm~ PEma-.r APPLICATION Y'O/ 3~ DAn /O/S;;;:: PEllIlIff shY3.?' :~'O /tr~' r=/'"V~<=~~ NEtl R.EI.AY REPAIR RIoa e ADDRESS OWNER NAnm! SAN SEll 'I fv L , , 'WATER I c:.:..........- Bath cub Sumo PUIIlD ~"Tn"M ~~ '-f fI \/ C Lavato1:T Ejector Toilet Water Softener T.NSPECTION DAD msncnON DAm fie. Sink Drinkin g Fountain rw/r;/5. ?rspJ SiDk(ac:he:;) Th-; n.<ll W.<lterheater Slop Sink Grease Trao Floor Drain Local Waste '?5"O Laundry Tub Site Drain Disposal Laundry Standpipe Dishwasher Catch Basin ** Violation notes on the reverse side(