HomeMy WebLinkAbout0036973-Plumbing (laterals) yd/
C111) CITY OF OSHKOSH No 36973
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG tgel SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 3 i V /,V
PLAN NO.
OWNER R
DESIGNER n
USE /NATURE OF WORK Ai s F k
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 e- 16-11
BT WH Disp WSoft CBasin
Lav Sh DW DF d Yi San. Sewer c
WC FDr SP Ur Storm Sewer Kt C
Sink LTub Eject SS l e......., Other Water
FEES: Valuation 6 Op O CJ 3 6
Permit Fee Paid 6/� Park Dedication
ISSUED BY Date j
Final /O. P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE C ,,�'6-Q33d -5---
AGENT /OWNER
ADDRESS 6 V d 0 N DATE
TELEPHONE
UMBING PERMIT APPLICATION 9 7
1 g 3 i 1 DATE l'%/
OWNER PL&cT#
ADDRESS
K PLm BER /(C.
NATURE OF WORE ICSFg
NEW RELAY REPAIR INTERIOR
(#J C
JA R Bathtub Su,. Put
STORK SEW U L Lavator9 Ejector
Toilet
Water Softener
4 Dig DATE INSPECTION DATE Eit. Sink Drinkin• Fountain
Sink other Urinal
SAli/S 1----S 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]