HomeMy WebLinkAbout0040600-Plumbing (laterals)/`'~ CITY OF OSHKOSH
PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG (~ SIGN
ADDRESS
OWNER
ZONING
~~/
N°- 40600
FLOOD PLAIN- _ _ _ _ .HEIGHT -
~~- ~ ~' SC
~4t~F NO.
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft. # 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 Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
- BT _ WH _ Disp _ WSoft - CBasin
~Gd~
- Lav _ Sh - DW _ DF ,f~ ,
San. Sewer ~~" L~ ~
WC _ FDr - Sp _ Ur ~ Storm Sewer ~~
U C
-Sink _ LTub _ Eject - SS /~
.~ Water ~ L.
Other
FEES: Valuation $ ~~~ ~ .~ ~ Permit Fee Paid $ ~ ~ ~ d Q Park Dedication $
_
ISSUED BY_~ ~~ Date ~ Final/O
P
.
.
In the
SIGNATURE
ADDRESS
of this work I agree to pertorm all work pursuant to rules governing the described construction.
~~ ~ _a~- ~
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~~~
DATE
TELEPHONE N
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ow1aER
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Nfr_w afrT_ ev vrs a re
PERK? APPLICATION
DATE ~ "'~ ~~ PSRIKIT# ~Q ~ ~J a
~~
~- p~ c~ --
SEf~ iL~J c- ~ # #
WATER Bathtub Su Pu
v~ Lavato Ejector
Toilet Water Softener
~ ~~ ~~~~ ~~ ~t• Slnk Drinkin Fountain
Sisk(other
W e heater Slo Sink
e se Tra
//~~ /~ Floor Drain Local Waste
~~,~~~~ ~~~% //~~
' Laundry Tu Site Drain
~~ Dis osal Laundr Stand i e
Dishwasher Catch Basin
** Violation not on the reverse side