HomeMy WebLinkAbout0022521-Plumbing (lateral)
~
CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
22521
TYPE:
BLDG D HTG D ELEC D PLBG II( SIGN D ZONING
FLOOD PLAIN
HEIGHT
OWNER
/ 7S.2.. #~L 6-4-
5~~>...~ ~ /~
PLAN NO.
ADDRESS
DESIGNER
AJJ4.J SF -Cl~ ~
USE/NATURE OF WORK
BUILDING CONTRACTOR
Size
Sq. Ft.
# Rooms
# Stories
Height
Occupancy Permit
Foundation
Class of Const.
HEATING CONTRACTOR
l1.
Hea.t D NC 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
_Lav
~WH
_Sh
_Disp
_DW
_SP
_DF
PLUMBING CONTRACTOR
_WC
_FDr
_ L Tub
_Ur
_ CBasin
~ San. Sewer
1 Storm Sewer
~ Water
_BT
_Sink
Other
_ Eject
_SS
!/ lu ~
</'f V c..
I~
FEES: Valuation $
ISSUED BY
/' t) ~ , C) d Permit Fee Paid $
&J~ Date
I
30. ~ 0
$/;/9/
, /'
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~.-
(~ AGENT/OWNER U
3-)-1(
DATE
ADDRESS
TELEPHONE #
6~#5?J
PLUMBING PERMIT APPLICATION _
ADDRESS ~~ DATE ,",/.2,/9,,: /
OWNER -.s:~~~PLUMBER /~
NATDRE OF WORK 4~ S;C - C>~ //4 p ~, -
NEW RELAY REPAIR INTERIO~
PERMIT4F P-;.2.3' ~ /
~~~_.~
SAN SEW V fJr./ C 4F 4F
WATER /~ Bathtub Catch Basin
STORM SEW Y /r/ ~ . Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPE CTI ON DATE Kit. Sink Local Waste
~~ w/o~ ~~I// Sink(other) Site Drain
Shower Laundry Stand Pipe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
TTrinals Future outlets
[** Violation notes on the reverse sidet