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HomeMy WebLinkAbout0040796-Plumbing (lateral) ~ CITY OF OSHKOSH PERMIT - APPLICATION AND RECORD ~o/ N!!-40796 :::E~~ ~L~~ ? - ~;E?~:~ ~: - ;7~- ~~~~D ~':':~~ ~~- - ~~I~~- - - - - OWNER t d~~_ DESIGNER B/ - 8~:L- r-ef USE/NATURE OF WORK BUILDING CONTRACTOR Size Foundation Sq. Ft. # Rooms # Stories Class of Const. I Height Occupancy Permit HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S J ELECTRIC CONTRACTOR Efectric Servo New 0 Change 0 Temp 0 Type Volts'_ Amps~ . Circuits Fixtures Switches Receptacles PLUMBING CONTRACTOR /t~ _BT _WH _Sh _FOr _ L Tub _Disp _OW _SP _ WSoft _OF _ CBasin -L San. Sewer --L Storm Sewer ---L- Water ~ _WC _Ur V-frJc- V,VC ( 4-.- _Lav _Sink Other _ Eject _SS FEES: Valuation $ /(?;g: 0 0- ~----- Permit Fee Paid $ Date / 3:"0_ a u / 7/z7/?~ / / 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~ ~ ~~~~()3.?.;J-c AGENT/OWNER ADDRESScP'7"~Y ~qtt:5A U/~~ L./ "?-~? .-y'~. DATE Sy~/6 .$"3~J?' /~ TELEPHONE # ADDRESS ~R ~ttm: .PL9)mfNG PEDt-r APPLICATION 'J DAm c,~o/57 Y G '/ ~ PLmmD. f .. (0 RELAY SAN SEttt.1 iolA'!ER NSPEcnON tI 11 7 ~jt ~ ViolatiCl'ft notes ClU the reverseside1, PEma-r# f'Co ,r 70 77 ~ # REPAIR nrrERIOR # Bath CUb !.4vato Toilet: DAt! Kit. Sink ~ Sink(other W te heater