HomeMy WebLinkAbout0019078-Plumbing (laterals)CITY OF OSHKOSH N°_ 19078
PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS ~ / PLAN NO.
OWNER /JC ~n l~l r'~iL- ,~
DES
USE.
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
Fixtures Switches Receptacles
PLUMBING CONTRACTOR /r
Volts Amps
Circuits
BT WH Disp "WSoft CBasin
Lav
_ Sh ~/
_ DW DF ~ San. Sewer 1 ~~~
WC FDr SP Ur ~torm Sewer
-Sink LTub Eject SS ~ Water ~.0'~--
Other
FEES: Valuation $ Permit Fee Paid $_~rl-- .~~ Park Dedication $
ISSUED BY Date ~ ~~ '! S
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENTIOWNER DATE
ADDRESS
TELEPHONE #
ADL+RE
OWNER o ivy
NATURE OF WORK
PLUMBING PERMIT APPLICATION t~
' DATE S-'~ ^ `~- PERMIT~k ~~Q~~
-~ PLUMBER ~~~' ~XCcvo ~ .~
EW RELAY REPAIR INNTERIOR
N 71
~, Batht
.~ Lava t
ON DATE ~( ~ Kit . Sink
Sink other
~~
Batch Basin
Grease Trap
Sum Pu
Local Waste
Site Drain
Floor Drain Laundr Tra
Dis osal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
.T_:...,i a Future outlets
V' la ion note on the reverse side