HomeMy WebLinkAbout0039511-Plumbing (laterals) CITY OF OSHKOSH
N!? 39511
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBGA SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS e 7 4 0 7 7 PLAN NO.
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OWNER
DESIGNER
USE /NATURE OF WORK _./CA .Z�;
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 S
BT WH Disp o ft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer �j'
Sink LTub Eject SS _L Water r C:c__
Other
FEES: Valuation C,40 ..C3 ..C3 Permit Fee Paid a J
Park Dedication
ISSUED BY fr/7/..--
Date Final /O.P. 5 -c.st y.9/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE di 1
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AG /O ER
P DATE
ADDRESS e
TELEPHONE
PLUMBING PERMIT APPLICATION
ADDRESS iii, 27-7/
DATE ''.11- PERMIT# 3, �5 O/
OWNER PLUMBER
NATURE OF WORE
NEW RELAY REPAIR INTERIOR
SAN SEW
WATER /1!.....4...- Bathtub Sump Pump
SSURM SEW Lavatory Ejector
Toilet Water Softener
INSPECTION DATE INSPECTION DATE Kit. Sink Drinking Fountain
Sink(other) Urinal
r S7•2 Waterheater Slop Sink
Sj ,Shower Grease TraD
Floor Drain Local Waste
Laundry Tub Site Drain
Disposal Laundry Standpipe
1 ,Dishwasher Catch Basin
Violation notes an the reverse side{