HomeMy WebLinkAbout0024923-Plumbing (laterals)P _CITY OF OSHKOSH N° 24923
ERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
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ADDRESS_ ~~S- ~ • o .1J.-~
(' PLAN NO.
OWNER y i~ y
DESIGNER
USE/NATURE OF WORK
9~-
BUILDING CONTRACTOR
Size Sq. Ft.
Foundation
# Rooms
# Stories Height .
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
-BT -WH
- Lav - Sh
- WC - FDr
-Sink - LTub
Other
Volts Amps
Circuits
- Disp
- DW
- SP
- Eject
- WSoft
- DF
- Ur
- SS
- CBasin
San. Sewer_
-Storm Sewer
Water
~p ~ ~
FEES: Valuation $ ~ ~~ d • d o Pertnit Fee Paid $ ~. ° ~ ~ Park Dedication $
ISSUED BY ~~ Date ~-~ ~ '-~ i' Final/O.P. ~ - a d -°l/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
GATE
ADDRESS
TELEPHONE #
ADDRESS °~~
OWNER ~~
NATURE OF WORK.
PL
NEW RELAY REPAIR
PERMIT APPLICATION
DATE ~ - °z
PLUMBER
INTERIOR
PERMIT~~ .2 j~~z 3
SAN SEW ~~ C ~ ~
WATER C...~ Bathtub Catch Basin
Lavato Grease Trap
Toilet Sum Pum
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink other Site Drain
S~(~ ~ ' _2IJ Shower Laundry Stand Pipe
Floor Drain Laund Tra
Dis osal Wat. Softner
Dishwasher D. Fountain
Water Heater Effector
' al Future outlets
** V'ola ion note on the reverse side