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HomeMy WebLinkAbout0011601-Plumbing (laterals) ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 11601 TYPE: BLDG 0 HTG 0 ELEC 0 PLBG J8.-. SIGN 0 ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - OWNER /;J(fO ,;t:2'd(t: /I-ur~ g C/~';c-S PLAN NO. ADDRESS DESIGNER USE/NATURE OF WORK Sf? ..-1'_<./ c~ L~/q~ BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. H~ATING CONTRACTOR Heat 0 NC 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 _BT V~ (" ~ Jr"" c Ic~ _ Disp _ WSoft PLUMBING CONTRACTOR _WC _Ur _ CBasin -I- San. Sewer ..L/ q fi/ c _ Storm Sewer /I -L Water / C ?I'--&.- _Lav _WH _Sh _Sink Other _FDr _LTub _DW _SP _DF _ Eject _SS / ;;i. OV ' ./ FEES: Valuat;on ~ _ ~ - Permit Fee Paid $ /~ k ISSUED BY -i?f73rp( Date , ~ q Park Dedication $ ~ Final/O.P. ;:t~~. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE ne' ~ ~~. I' Z'/ AGENT/OWNER ", ADDRESS DATE TELEPHONE # ADDRESS OWNE R PLUMBING PERMIT APPLICATtON //-RO I-Iu~ :~:'E;6~~~>~~T~t61 NATURE OF WORK NEW ~~ - SAN SEW 4t( iF if WATER J (;, Bath tub Catch Basin STORM SEW Lavatory Grease Trap Toilet Sump Pump INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste F 6(r~~ Sink(other) Site Drain Shower Laundry Stand Pipe Floor Drain Laundrv Tray Disposal Wat. Softner Dishwasher D. Fountain Water Heater Ejector Tlrinals Future outlets RELAY REPAIR INTERIOR r** Violation notes on the reverse sidel