HomeMy WebLinkAbout0025970-Plumbing (laterals)
~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECOR,D
25970
TYPE: BLDG D HTG D ELEC D PLBG J4( SIGN D ZONING
FLOOD PLAIN
HEIGHT
::N::~ . . . . . . . . . .; i~:5 . . . . . . . . ~LA~ ~~. . . . . . . . . . .
/
DESIGNER
;U~ ~rl- 6~rL7'
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
Heat D AlC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo New D Change D Temp D
Type_ Volts_ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR J( ~
~
_BT _WH _Disp _ WSoft
~ _Lav _Sh _OW _OF
_WC _FOr _SP _Ur
_Sink _ L Tub _ Eject _SS
Other
_ CBasin
~ San. Sewer
~ Storm Sewer
-L Water
W$-
V/JC
'/fJC
I~
FEES: Valuation $
ISSUED BY
1700,0 c
Permit Fee Paid $
~
36.,0 C V
/0...- # 3--9/
Park Dedication $
Final/O.p~ -~-9;)
w~
, .
Date
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ~<-~ ~ ~RS:0373~~
AGENT/OWNER
ADDRESS rt;-v7" d6 .5'ct ~. ~ CJL--; 1~G5
/d-.-/3---9/
DATE
~J"~~ r ?~ J>
TELEPHONE #
"
ADDRESS
OWNER
NATURE
PLUMBING PERMIT APPLICATION
/,{,?6~~~~~ C-~-;o- J . DATE lo,-c .;L~
~- f: ~ , P~YMB. ER d
OF WORK /I/~s: F I!. -O~. ~
NE\o1 RELAY REF AIR INTERIOR .
PERMITJF /s;:-/ 70
~
SAN SEW 'ff\J~ JF JF
WATER I~ Bathtub Catch Basin
S' HIM SEW, if {Iv L . Lavatorv Grease Trap
, Toilet I Sump Pump
INSPECTION DATE INSPECTION DATE Kit, Sink Local Waste
~~~f to - 9;2 -9/ Sink(other) Site Drain
Shower Laundry Stand P1.pe
Floor Drain Laundry Tray
Disposal Wat, Softner
Dishwasher D. Fountain
Water Heater Ejector
n"'inals Future outlets
..,
1** Violation notes on the reverse side!