HomeMy WebLinkAbout0039100-Plumbing (laterals)7"a
/~ CITY OF OSHKOSH N° 39100
`' PERMIT -APPLICATION AND RECORD
TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT
-----------------------------------
ADDRESS ~ l~ ~ ~'(/ PLAN NO.
OWNER ~G-~r
DESIGNER
USE/NATURE OF WORK ~ ~ '"
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 Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
- BT - WH _. DisP - WSoft _
- CBasin ~/ Q G
- Lav - Sh - DW - DF _L San. Sewer ~` / ~ ~
- WC - FDr - SP - Ur
/ Storm Sewer_ ~ ~ ~
-Sink - LTub -Eject - SS / l~ --
Water__
Other
FEES: Valuation $ ~~d C ~ ~ ~ Permit Fee Paid $ -~ ~ ~ Q ~
// 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 ~.5~~~ S ~'-,~y
AGENT/OWNER
ADDRESS Pt ~~~ ~ ~ ` DATE
Gui S~®C ~~_~ -~~t~zs-
TELEPHONE #
~~
a~R
~zoRE of wow ~F -
~B~z a~ r=oe
~ DAZE ~ ~ ~ 9 ~ PERI~T# ~ ~~~
,__,~. ~R
NEid REIJ-4 RFpeTR U TN'1'RRTAR
/!
WATER Bathtub Sum Pu
~~ Lavato Ejector
Toi et Water Softener
OIL TE IIQSPECZZOIQ DAZE Rst. Sink Drinkin Fountain
Siak(other
~Q ~' W to he ter Slo Sink
ease Tra
Floor Drain Local Waste
Laundry Tu Site Drain
Dis osal Laundr Stand i e
Dishwasher Catch Basin
~` /S dQ _ po
** v, slat: ~++_ ....«.. oa ~s reverse side