HomeMy WebLinkAbout0025308-Plumbing (laterals)_CITY OF OSHKOSH N° 25308
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS ~ ~'Z' // ~z
OWNER
DESIGNER
USE/NATURE OF WORK
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 ~ f1 ~ ~'
~- WC ~' FDr SP Ur Storm Sewer
-. Sink ~ LTub ~~ Eje/cft SS ~ Water ~ ~-~--
Other ~ ~ C L-- ~~"-ass" ~-'c~_ t,~''
Y
FEES: Valuation $ oZ S O ~ • ~ d Permit Fee Paid $ ~ ~
~ 0
~ Park Dedication $
ISSUED BY ~ Date ~ `~I~ `~/
~~
Final/O. P.
) ~ - ~ 1
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUI
DATE
ADDRESS
PLAN NO.
TELEPHONE #
a~a°4°D
PLUMBING PERMIT APPLICATION
ADDRESS ~ ~ ~ -~ • DATE ~ _ ~ ~ ~ r~'O PERMIT~k 2S~ ~ e g
OWNER .PLUMBER "~
NATURE OF WORK ~ ~ ~-~ f"" ~ -
NEW RELAY REPAI INTERIOR
SAN SEW IJ L ~ ~~
WATER C-~.--c- Bathtub Batch Basin
Lavato Grease Trap
Toilet Sum P
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
~, ~`
~~ Sink other) Site Drain
°
/ n / r Shower +~ Laundry Stand Pipe
C~ ~ ~ r~ ~ / Floor Drain / Laund Tra
Dis osal Wat. Softner
~= ~ "'~ ~ ~ Dishwasher D. Fountain
Water Heater Ejector
A Future outlets
** V"olation note on the reverse side
C3 C~ -
_.