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HomeMy WebLinkAbout0020165-Plumbing (water lateral) ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 20165 TYPE: BLDG 0 HTG 0 ELEC 0 PLBG ro SIGN 0 ZONING FLOOD PLAIN HEIGHT ... ... ... ... ... .. ... ... ... ... .. .. .. .. .. ... .. .. .. .. .. .. .. .. .. ... - .. .. .. .. .. .. .. .. ... ... .. ",< .. .. ... .. ... .. ... .. .. .... - .. .. ..; .. - .. .. ... .. ... ... .. .. .... - ...... .. ... ';-.,).~$ ~ ~~~~ PLAN NO. ADDRESS OWNER DESIGNER USE/NATURE OF WORK u~~~~ BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATING CONTRACTOR Ke",t 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 _WH _Sh ~~ (J - Disp _ WSoft PLUMBING CONTRACTOR _WC _FOr _ L Tub _OW _SP _OF _ CBasin _ San. Sewer _Lav _Ur _ Storm Sewer LWater / tr~ _Sink Other _ Eject _SS FEES: Valuation $ 2(!;JC; .6--e ISSUED BY ~ ~ Permit Fee Paid $ Date /CJ . C> 0 g- ~..2-- y-~ Park Dedication $ Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATUR/~ ~" ADDRESS DATE TELEPHONE # ADDRESS OWNER NATURE OF WORK NEW DATE PLUMBER .R~/t.s- (.0~ SAN "SEW If If WATER I ['cv:.: Bathtub Catch Basin STORM SEW Lavatory Grease Trap Toilet Sump Pump INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste 5'~. e>h" ? /.,l7.9o Sink(other) Site Drain Shower Laundry Stand Pipe Floor Drain Laundry Tray Disposal Wat. Softner Dishwasher D. Fountain f; ~<P Water Heater Ejector 10 Y' TTrinals Future outlets RELAY REPAIR INTERIOR IIJ;t-t~~ "I. W~.s~. [** Violation notes on the reverse sidel