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HomeMy WebLinkAbout0020166-Plumbing (water lateral) ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 20166 TYPE: BLDG 0 HTG 0 ELEC 0 PLBG ~ SIGN 0 ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - OWNER CJ-;>-..2- -b ~ (07-' ~~ PLAN NO. ADDRESS DESIGNER USE/NATURE OF WORK &)~ ~~ 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 ELECTRIC CONTRACTOR Electric Servo New 0 Change 0 Temp 0 Type _ Volts _ Amps_ Fixtures Switches Receptacles Circuits _WC _WH _Sh _FDr _LTub ~~.. (/ . _ Disp _ WSoft _DW _DF PLUMBING CONTRACTOR _BT _ CBasin _Lav _ San. Sewer _ Eject _SS _ Storm Sewer / /"~ -'-- Water _SP _Ur _Sink Other Permit Fee Paid $ Date , ,r6.b Co g -~ ~ '-'7;:) Park Dedication $ Final/O.P. FEES: Valuation $ /00.00 CL:... /) /J/J . ISSUED BY ~ ~ In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE ~ ADDRESS t/' ~~~. AGE NER DATE TELEPHONE # ADDRESS OWNER NATURE OF WORK c;E~;26 PLUMBING PERMIT APPLICATION Ji.~~/~ :~:'ER 1j"p~ c~~~/Gh lU~~~ u.J SAN SEW 4F 4F WATER / 'C-u<- Bathtub Catch Basin ~TORM SEW Lavatory Grease Trap Toilet Sump Pump INSPECTION DATE INSPE CTI ON DATE Kit. Sink Local Waste ~~ i.l-o/7O Sink(other) Site Drain e/l Shower Laundry Stand Pipe Floor Drain Laundry Tray Disposal Wat. Softner ?' DO Dishwasher D. Fountain I V ;..-- Water Heater Ejector Hrinals Future outlets I __w '-'S'~~ NEW RELAY REPAIR INTERIOR t** Violation notes on the reverse sidet