HomeMy WebLinkAbout0021038-Plumbing (laterals)_CITY OF OSHKOSH N°_ 21038
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS /' ~'~-"' PLAN NO.
OWNER ~~~'"
DESIGNER
USE/NATURE OF WORK ~-~-~ ~--w-
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type Volts Amps
Fixtures Switches Receptacles Circuits
~ # ~ ~
PLUMBING CONTRAC TOR .~~-~-
BT _ WH Disp WSoft CBasin E'`'
~
Lav Sh DW DF ~ San. Sewer /'
~ r(+ ~C
WC FDr SP Ur -Storm Sewer
-Sink LTub Eject SS r Water ~ ~( P ~
Other
I
FEES: Valuation $ ~° ~ ~ ~ Q Permit Fee Paid $ °Z ° ~'' ~ Park Dedication $
ISSUED BY ~- Date ~~ ~% g~ Final/O. P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
DATE
~~~ DC `~~
TELEPHONE #
ADDRESS
AGENT/OWNER
PLUMBING PERMIT APPLICATION
ADDRESS l~ DATE ~~~ 9~ ~pO PERMIT~k °Z~G' 3
OWNER ~~~ ~ ~ PLUMBER +1 ~ i~ ~-~-e.~= _
NATU'_:E OF WORK :~ ..P~c,tL. ~
NEW RELAY REPAIR INTERIOR
SAN SEW ~m ~~L ~~ ~~
WATER /"` ~- Bathtub Catch Basin
TORM SEW Lavator Grease Trap
Toilet Sum Pum
INSPEC ION DATE INSPECTION DATE Kit. Sink Local Waste
~ ~r/~ ~ j~.yJ~~ ~~_ Sink(other) Site Drain
~'( ~ Shower Laundry Stand Pipe
~ - 1 3 ~
/
~
~
~ Floor Drain Laundr Tray
~
~
~
~
~U ~ Dis osal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
rinals Future outlets
** Violation notes on the reverse sid