HomeMy WebLinkAbout0028033-Plumbing (laterals) CITY OF OSHKOSH N°_ 28033
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG 6 SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS j f PLAN NO.
k dc-,,,,(
OWNER
DESIGNER
USE /NATURE OF WORK AI sF R i
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 je/2,p-t
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer S P C
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS j_ Water
Other
FEES: Valuation a d Permit Fee Paid 6 Park Dedication
ISSUED BY L Date 5 l- f C/7 2- Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE U r
AGENT /OWNER DATE
7' 7
ADDRESS
TELEPHONE
DNB PERMIT APPLICATION
ADDRESS. a 3 5; l DATE 3 —9s PERMIT# 2 8033
OWNER R -1
NATURE or WORE 4 A
1 ,r, RELAY REPAIR INTERIOR
WATER Bathtub Sump Pun
its Y a. Lavato E'ector
Toilet Water Softener
INSPECTION DATE ImPECTION DATE Rit. Sink Drinking Fountain
,.0 Sink(other) TTrinal
��E °'�`l� Waterheater Slop Sink
Shower Grease Tray
Floor Drain Local Waste
Laundry Tub Site Drain
'Disposal Laundry Standpipe
Dishwasher Catch Basin
Violation notes on the reverse side(