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HomeMy WebLinkAbout0039102-Plumbing (laterals)/~ CITY OF OSHKOSH No `' PERMIT -APPLICATION AND RECORD TYPE: BLDG ^ HTG ^ ELEC ^ PLBG [fJ -------------------------- --- ADDRESS ~ ~~ OWNER DESIGNER ~/ 39102 GN ^ ZONING _ - _ FLOOD PLAIN - - HEIGHT - PLAN NO. 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 Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR -BT -WH - Lav _. Sh - WC - FDr - Sink - LTub Other Amps - Disp - DW - SP -Eject - WSoft - DF - Ur - SS - CBasin ~i~" ~ San. Sewer ~l ~ ~- -Storm Sewer Water ~ ~~-- FEES: Valuation $ 3 is ~ ff . 8 ~ Permit Fee Paid $ ~ Q ` ~ ~ Park Dedication $ ISSUED BY Date '~ 7 ~ Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. 1 SIGNATUR %~?~S'x 2.?~ ~ SOS c AGENT/OWNER ~~-9f/ DATE ~~ -i~~~ TELEPHONE # ~•D 06JNE8 ~°~ NATURE OF WORM ~-S ~6 PLUI~IPG PERffi't APP.LICA IO ~ tG ~~ia NEi1 RELAY REPAiR DATE ______ ~T# ~ Z PLDP~LR AN ~ i~ ~- - - -- ---- ~ -- - - # WATER Bathtub Su Pu Lavato Ejector Toilet Water Softener ON 1E SPE DAZE Ri.t. Sink Drinkin Fountain ~ / Siak(other L W to heater Slo Sink G ease Tra Floor Drain Local Waste ~~ Laundry Tu Site Drain Dis osal Laundr Stand i e Dishwasher Catch Basin ~~3<p o ©. rJ ** Violation nor.. on ~e revezae side