HomeMy WebLinkAbout0027436-Plumbing (laterals)_CITY OF OSHKOSH N°_ 27436
PERMIT APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS ~~~ // ~~- PLAN NO.
OWNER ~ ~ _ L
DESIGNER
USE/NATURE OF WORK ~-~
BUILDING CONTRACTOR
Size Sq. Ft
Foundation
# Rooms # Stories
Class of Const.
Height .
Occupancy Permit
HEATING CONTRACTOR
Heat ^ A/C ^ Vent ^ Fuel/System
ELECTRIC CONTRACTOR
Electric Serv. New ^ Change ^ Temp ^ Type
Fixtures Switches Receptacles .
PLUMBING CONTRACTOR
- BT WH _ Disp
Lav -Sh DW
WC FDr SP
-Sink _ LTub Eject
Other
- WSoft
DF
Ur
SS
- CBasin
f San. Sewer ~~~ L
-Storm Sewer
Water l ~-~
FEES: Valuation $ ~~ ~ ~ • Q O _ Permit Fee Paid $ `~ ~ ° ~ Park Dedication $
ISSUED BY ~ Date ~ ~'2 ~' 9 ~-- Final/O
a -a`~` ya
P
.
.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT/OWNER
ADDRESS
Heat Loss
BTU'S
Volts Amps
Circuits
DATE
TELEPHONE #
PL~IDINC PL-Bl~? APPLICa1'ION
',OWNER
DATE
PLDtIDLB
NATflBE OF GTORL
1QEi,T RELA4 RE4A
2A1TL-gI08
~, PEAL~T# 1 ~ i~ 93 ~
`~ 8 Cw Bathtub Sum Pu
Lavato E'ector
e Water Softener
~ INSPECIZON ~~ ~•t• Sink Drinkin Fountain
Sialc other
S` (~ .~ - ~ ~ e to Slo Sink
/ e se Tr
Floor Drain Local Waste
Laundry u Site Drain
Dis osal Laundr Stand i e
Dishwasher Catch Basin
** Vinlatinn net.. on the reverse side