HomeMy WebLinkAbout0015622-Plumbing (laterals) CITY OF OSHKOSH N2 15622
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG A. SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS /0/ 03 7 05' a 7 C 'r O c7 PLAN NO.
OWNER Z7t A
DESIGNER
USE /NATURE OF WORK i -a
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 7 -J L.E0?il iy-
BT WH Disp WSoft CBasin
Lav Sh DW DF _4 San. Sewer
C
WC FDr SP Ur Storm Sewer
4
Sink LTub Eject SS 4 Water
Other
FEES: Valuation Permit Fee Paid $I2-0 Park Dedication
ISSUED BY_��
Q-
Date 27' gyp Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS.
TELEPHONE
PLUMBING PERMIT APPLICATION
Sl-
ADDRESS /=i 0 1 /44 PERMIT
OWNER 0 1,E Q cl<.T 0c,4, PLUMBER J s j jCel r Z
NATURE OF WORK .wit.✓
NEW RELAY REPAIR INTERIOR
SAN SEW 1
WATER Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit Sink Local Waste
Sink(other) Site Drain
Shower Laundry Stand pipe
4 "ciP Floor Drain Laundry Tray
p/ Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector'
i _Urinals Future outlets
J** Violation notes on reverse side