HomeMy WebLinkAbout0016811-Plumbing (laterals)~ CITY OF OSHKOSH N°_ 16811
` PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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. ' _
ADDRESS
PLAN NO
/ /_,,[_
OWNER T~ C k~ L-~~l-~ ~~'
DESIGNER
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USE/NATURE OF WORK
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 ~
BT
Lav WH
Sh Disp !
DW ' WSoft
DF CBasin ~/
~ San. Sewer r H ~L'~
WC FDr SP Ur -Storm Sewer
-Sink LTub -Eject ',~ SS ~ Water ~ ~C~ n?' ~^
Other
o-a ~_
FEES: Valuation $ Permit Fee Paid $ ~~ Park Dedication $
ISSUED BY ~/.vim Date `~~ ~~ Final/O.P. ll~~~
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
ADDRESS
Sq. Ft
AGENT/OWNER
DATE
TELEPHONE #
ADDRESS
OWNE R
NATURE OF WORK
PLUMING PERMIT APPLIC TIO ,
DATE ~ PERMIT ,~k /V l
.~ ~ PLUI~ER t
n c.t •v nc n~TV ' TUTG'RTl1R
SAN SEW L~nw •~uuni -
~k -_ _--
~k
WATER athtub Catch Basin
STORM SEW avato Grease Tra
Toilet Sum Pum
ECTION DATE INSPECTION DATE Kit Sink Local Waste
//
~ Sink other) Site Drain
j
~rcu cry
1~18~~ / ~ ~~ lZp
11 ~~ Shower Laundry tan pipe
~
// Floor Drain Laundry Tray
Disposal Wat. So tner
Dishwasher D. Fountain
Wa,t~r Heater Ejector'
Urinals Future outlets
** Violation notes on reverse side