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HomeMy WebLinkAbout0041763-Plumbing (laterals)~~ CITY OF OSHKOSH N°- 41763 n PERMIT -APPLICATION AND RECORD TYPE: BLDG ^ HTG ^ ELEC ^ PLBG SIGN ^ ZONING FLOOD PLAIN HEIGHT ~~~~ ADDRESS PLAN NO. OWNER DESIGNER USE/NATURE OF WORK ~~ ~ © ~~ 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 Senr. New ^ Change ^ Te mp ^ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR - BT _ WH _ Lav _ Sh _ Disp DW - WSoft _ DF _ CBasin ~ ~ San. Sewer ~ ~ ~ - WC _ FDr _ SP _ Ur ~ Storm Sewer C ~ ~ C -Sink _ LTub - Eject _ SS ~ Water Other ~e;Cs-G FEES: Valuation $- _ ~~~~ ~ Permit Fee Paid $ Park DedicatioGn $ ISSUED BY ~~~~~- Date ~ ~7 9 Final/O.P. 7 •~-y' ~~ In the performance of this work I agree to perform all work pursuant to rules governing the described construction. ~~~ SIGNATU 9~~ 7- r~ ` AGENT/OW(y `/ ,, ~ DATE ADDRESS ~5r Lr~r~~C ~ ~ ~'GIC O~~ U/! p~S-v/r TELEPHONE M rL~n~c ~xra~r a~r~cazzoN ~/ 7 ~,~ .~ ~ S pE&!IT# aDDaESS ~ g~f` nay ow~R NATURE OF WG~ S ' ~ ....w ...w RT AR @IP:I+I ~L 1[CL111 ~ w:raata~ # - # WATER Bathtub Lavato Sum Pu Ejector Toilet Water Softener ~ DATE Ipgpg~pg ~j~ Rit. Sink Drinkin Fountain Siak(other , / W to heater Slo Sink S ~ ~ ~ ~ ~ ,~~ ~` e se Tra ~~ / G Floor Drain Local Waste Laundry Tu Site Drain Dis osal Laundr Stand i e Dishwasher Catch Basin ** Violation notes on the revere side