HomeMy WebLinkAbout0030135-Plumbing (laterals)/~ CITY OF OSHKOSH N°_ 30135
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
ADDRESS 75 ~
PLAN NO.
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
Fixtures Switches Receptacles .
Volts Amps
Circuits
PLUMBING CONTRACTOR
-BT -WH
Lav Sh
WC _ FDr
-Sink _ LTub
Other
Disp
DW
SP
-Eject
- WSoft
DF
Ur
SS
- CBasin
~ San. Sewer ~ ®~ ~
-Storm Sewer /
Water ( `"~`-
FEES: Valuation $ ~ b ~ ~ ' a d Permit Fee Paid $ ~/ ~/•~ ~ ~ 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
ADDRESS you
ail. iylo~e•~.,.i
AGENT/OWNER
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~-/a_ ~z.
DATE
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TELEPHONE #
~sv 17
OWNEB
NAIUBE OF G10RS
PERMIT APPLIC.'~TION
DATE ~ -/ 5 - 9 z PERK?# .~ c7 / 3 .~
PLDM8E8
tv~ra tt~_ev rrnos~ ~TnA
Q~ ~ -- - ---- ~ -- -- ~
WA ~ ~" Bathtssb Su Pu
Latrsto E' ector
To' et Water Softener
~ ~~~~ ~~ R$t• Sink Drinkin Fountain
S 3iak other
/LC.~ W e he ter Slo Sink
~..,~~ e se T a
Floor Drain Local Waste
Laundry Tu Site Drain
~
~/,,~~ Dis osal Laundr Stand i e
,
~,~9,~,~,~~T 7~'L~_~'~_n ~ Dishwasher Catch Basin
*+~ Violation notes on the reverse side