HomeMy WebLinkAbout0033864-Plumbing (laterals) s
CITY OF OSHKOSH N2 33864
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG 0 SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS /c //U PLAN NO.
1
OWNER
DESIGNER
ii.......e,
USE /NATURE OF WORK IV Sl- k Q
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 6— 6.
saP
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer 7` Pt/
WC FDr SP Ur Storm Sewer V/ I/ C
Sink LTub Eject SS _L Water
Other
0
FEES: Valuation its/ Permit Fee Paid 0 0 0 Park Dedication
ISSUED BY Date �//7, 3 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
i
SIGNATURE r� f e
AGENT /OW 41 S.1' DATE��
ADDRESS ii' di (a. .,Z 1 �(Y 5 z'e�U 2'q- ,i 6 P
TELEPHONE
KO/
11 LING ING PERMIT APPLICATION
ADDRESS, /0/-6 DA=L 7 9 FERN# 3 X
OWNER t .A_ A: i L r- L __mot
NATURE OF WORK A/ S,: 0 /1t" .i
r
NEW RELAY REPAIR r BI0R
SEW JC
WATER 110M-211 Bathtub
Su i Pu
k•M;.,Y 3A. IMAM Lavatory Ejector
Toilet Water Softener
INS ON DATE INSPECTION DATE Kit. Sink Drinking Fountain
Sink(other) TTrinal
•G ST s/17 Waterheater Slop Sink
Shower Grease Trap
Floor Drain Local Waste
Laundry Tub Site Drain
'Disposal Laundry Standpipe
Dishwasher Catch Basin
Violation notes on the reverse side]