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HomeMy WebLinkAbout0019059-Plumbing (laterals)ADDRESS ~ -~" C~;~JNER NATURE OF WORK PLUMING PERMIT APPLICATION DATE ~ ~ ~~ - PERMIT~~ J~ ~~ PLUMER ' ~e' xRw RF.T.AY RF.PAtR INTERIOR SAN SEW ~ ~k ~k WATER ~ Bathtub Catch Basin RM EW ~' Lavator Grease Trap Toilet Sum Pum INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste Sink other) Site Drain /,y~-'~ ~/,~/G!~ Shower Laundry Stand Pipe j° ~ T Floor Drain Laundr Tra Dis osal Wat. Softner Dishwasher D. Fountain Water Heater Ejector finals Future outlets ** Violation notes on the reverse side CITY OF OSHKOSH N° 19059 PERMIT -APPLICATION AND RECORD TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT -------------------------------------------------------------------- ADDRESS OWNER_ DESIGN USE/NA' 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 BT WH _ Disp WSoft _ CBasin - Lav _ Sh DW _ DF ~ San. Sewer ~~+i°!!C - WC _ FDr SP _ Ur ~ Storm Sewer ~~~%'~~` ~~ -Sink LTub Eject SS N ~ Water ~ l(.~g,L2~ Other ~ ~ FEES: Valuation $ ~~L~7~ Permit Fee Paid $ ~ ~~~ Park Dedication $ ISSUED BY ~~ / ~ E~z ~ Date ~ ' =~-Z'j~d Final/O.P. 5-C~~ ~~ In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE ~~ ~~ ~/ ~E'$ o.33~S'- V' ~~ -- ~d AGENT/OWNER DATE ADDRESS TELEPHONE #