HomeMy WebLinkAbout0043315-Plumbing (laterals)~/
/~ CITY OF OSHKOSH N°-~ 43315
~' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS
OWNER
DESIGNER
USE/NATURE OF WORK
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 Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR ~~ V
- BT _ WH _ Disp _ WSoft ._ CBasin
- Lav
_ Sh
_. DW
_ DF
~ San. Sewer r
`t" ~ ~ ~'
. WC _ FDr - SP _ Ur ~ Storm Sewer ~~
~ ~'
-Sink _ LTub -Eject _ SS ~ Water__ r~
~ ~=c~--
Other
FEES: Valuation $
~~ - ~ U
Permit Fee Paid $ v
3
~ - ~
Park Dedication $
ISSUED BY ~ I~afa `
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In the performance of this work I agree to perform all work pursuant to rules governing the described construction
SIGNATURE
ADDRESS
.~~ ~ O
l., ~Z
DATE
~ 2,j
TELEPHONE
pEBI~II? ppPLIC.ITION
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~a* .e n~ s T~ TNTL-RIOfi
AN lain
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WATER
L Bathtub
Lavsto Sum Pu
Ejector
Toilet Water Softener
ON DATE INSPECTION DA1E R£t. Sink Drinkin Fountain
Si.ak(other
,~"'
C W t e ter Slo Sink
~~ e se Tra
Floor Drain Local Waste
Laundry Tu Site Drain
Dis osal Laundr Stand i e
Dishwasher Catch Basin
O ~
** Violation notes on the reverse side