HomeMy WebLinkAbout0031211-Plumbing (laterals) CITY OF OSHKOSH N° 31211
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN El ZONING FLOOD PLAIN HEIGHT
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ADDRESS PLAN NO.
OWNER e do_,,,v,,--
DESIGNER
USE /NATURE OF WORK
/V- F
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
BT WH Disp WSoft CBasin
e,pti C
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer G
Sink LTub Eject SS 4 Water r
Other
1
FEES: Valuation 70 0 O 6 Permit Fee Paid 3 O a Park Dedication
ISSUED BY 7 Date --87. S v Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE J� 2,, AGENT /OWNER DATE
ADDRESS
TELEPHONE
1 INC RlRlaT APPLICATION
73 /'l' 4 �/'4 DATE 9 g PERMIT# a
PiDDRESS p
OWNER K PLUy
MBER �I�
NATURE of way AF R
NEW RELAY REPAIR OR
SAN SEW Y94/ C I
WATER /C-4--- Bathtub Sump Pump
S?QFM SEW c(NC- 'Lavatory Ejector
Toilet Water Softener
INSPECTION DATE INSPECTION DATE Kit. Sink Drinking Fountain
Sink(other) Urinal
/41i) °I _g Waterheater Slop Sink
Shower Grease Trap
Floor Drain Local Waste
c? ..-,2, t) Laundry Tub Site Drain
Disposal Laundry Standpipe
'Dishwasher Catch Basin
Violation not on the reverse side(