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HomeMy WebLinkAbout0020970-Plumbing (laterals)_CITY OF OSHKOSH N° 20970 PERMIT APPLICATION AND RECORD TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT ~~ ADDRESS °~ y~~ '/ ~-~G~ C~~ ~ PLAN NO. OWNER ~~ DESIGNER ~ ~ e USE/NATURE OF WORK ~ ~~ `e!' ~ tU ~2f~ ~ 5~,.,, ~c~ ~. ~ ~lz~,cu ~i7t~ i BUILDING CONTRACTOR i Size Sq. Ft. # Rooms # Stories Height I Foundation ! Class of Const. Occupancy Permit i i HEATING CONTRACTOR ' Heat ^ A/C ^ Vent ^ Fuel/System I Heat Loss BTU'S I ELECTRIC CONTRACTOR Electric Serv. New ^ Change ^ Temp ^ ~ Type Volts Amps Fixtures Switches Receptacles Circuits i PLUMBING CONTRACTOR ~ BT WH Disp i WSoft CBasin ~"~ Lav Sh DW DF ~ San. Sewer ~'' N PG ~ WC FDr SP ~ I Ur ~ Storm Sewer S' ~ /°v c -Sink LTub Eject SS ~ Water ~ ~~ n ~, Other I i FEES: Valuation $ ~y~'° i Permit Fee Paid $ ~d . s-y Park Dedicat io n $ ISSUED BY_ R `-~~'~- .~ Q - ~ Date ~~ Final/O.P. 8 ~~ ~ '- ~(,~ In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE ~`~~ ~" %~~'~ ©~s~o? S''- ~4~-/.~--y0 AGENT/OWNER DATE ADDRESS TELEPHONE # PLUMBING PERMIT APPLICATION ADDRESS ~~ J ~ DATE '"~ ~ .~ ~ ~~ PERMIT~k ~ ~ ?~ JWNER ~ PLUMBER MATURE OF WORK ~ `r ~ fr raFra RF.T.AV RF.PATR INTERIOR SAN SEW ~{ P ~ C ~k ~~ WATER / Bathtub ~ catch Basin SEW U G Lavato Grease Trap Toilet Sum Pum INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste Sink other) Site Drain Shower Laundry Stand Pipe f~ ~~ / 7~ 9° Floor Drain Laundr Tra Dis osal Wat. Softner Dishwasher D. Fountain Water Heater Effector finals Future outlets ** V'olation notes on the reverse side