HomeMy WebLinkAbout0014769-Plumbing (laterals)/'~ CITY OF OSHKOSH N° .14769
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS_
OWNER_
DESIGNER
USE/NATUF
PLAN NO.
~0 _
BUILDING CONTRACTOR
Size
Foundation
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
# Rooms # Stories
Class of Const.
Heat Loss
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures Switches Receptacles
Volts
Circuits
Height _
Occupancy Permit
BTU'S
Amps
~
PLUMBING CONTRACTOR /~ ~
'1~L~,~ 4='~---
BT WH Disp WSoft CBasin
Lav
Sh
DW
DF ~~v~
San. Sewer
~~~~~~
~~..,,
WC
FDr
SP
Ur ,,
~
~t6rm Sewer"'T"~"~'`~
Sink LTub Eject SS ~ Water ~ G' ror~~J~-~-
Other
c~ii C7as
FEES: Valuation $ Permit Fee Paid $ ~,r~ Park Dedication $
ISSUED BY Date ~'- ,~- Final/O. P. ~~~-~~
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE L
AGENT/OWNER
7DRESS
Sq. Ft
DATE
TELEPHONE #
ADpRESS_ ~'`~,
OWNER -
NATURE OF WORK
N
R
PLUMBING PERMIT APPLIG.9TIDN~`
DATE ~~~ / ~ PE RMI T# /'
PLUMBER _ r t~~~~ - _~~
'. ,.i ~•
REP
ON DATE
~ ~~~/~
NTERIOR
~~ ~~
Bathtub
Lavator
Toilet
Kit. Sink
Sink(other)
Shower
Disposal
~~ 51~1/(ft„L s Dishwasher
~`~~~- Water Heater
tch Basin
ease Tran
Local Waste
Site Drain
Wat. Softner
D. Fountain
Effector
Future outlets
** Violation notes on the reverse side