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HomeMy WebLinkAbout0033871-Plumbing (laterals) ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD YO/ 33871 ~~P_E~ _ _ ~L~~ _~ _ ~T~ _ C? _ ~~E~ _ C? _ ~~B~ ~ ~I~~ _~ _ ~O_N~N~_ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _ d:U~~ ( DESIGNER ~ USE/NATUREOFWORK Als.;=1!. ~ 6> ~~ ADDRESS PLAN NO. OWNER BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ~ Ii ELECTRIC CONTRACTOR Electric Servo New 0 Change 0 Temp 0 Type _ Volts _ Amps_ Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR E~D;S~ ~WSO" _WC _Ur _ CBasin ~ San. Sewer ~ Storm Sewer -/- Water ~ _Lav _WH _Sh _BT _ Eject _SS ~ -fu c. Y:fu c Ie.- _Sink Other _FDr _ L Tub _DW _SP _DF ISSUED BY /OC>6.00 ~ Permit Fee Paid $ Date / '3:0,0'0/" 7"/7/;> ~ I' Park Dedication $ Final/O.P. FEES: Valuation $ In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE L2~h rP . . AGENT/OWNER /?J a L;~ ~6 7._ ~ /i4?4''- ~~ 1t;J1.S'74'0 5" "'/)}--9~ DATE - ADDRESS 2ql/- r?1i'/E TELEPHONE # ,~,.'...."; -.::'.':>:",':'f.f~,:':,~t,\;"',~,,,_ SAN SEY iJA'I!R ,K(J/ ~~=~ /~_ 6-. .. ~ "://7(;3 PEllHI'!' 53!??1 & /~~",~ E:~E~. OJ' ~01UC /(ls r - 0 1/ ~ REI.AY REPAIR OR. ~ Je # / Badleub Lavaeo Toilee Kie. Sink SiJUc.(oeher W te heat'er # :\DDIESS CTiNElt NAnm.! "I PECTION 5YW DAI! msncnorr ~o l)A'!! Su Pu Ejector Water Softener Drinkin Fountain , ." Floor Drain Laundry Tu Dis osal Dishwasher ** Violaeion noee!! on the ~vene !ide(