HomeMy WebLinkAbout0041019-Plumbing (laterals) CITY OF OSHKOSH N9 41019
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC p PLBG i SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS /3 W 6' V °P' f PLAN NO.
OWNER 4
DESIGNER A/
USE /NATURE OF WORK 0 t
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
Lay Sh DW DF f
San. Sewer 1 c
WC FDr SP Ur Storm Sewer %P U C
Sink LTub Eject SS Water
Other
FEES: Valuation C d C9 Permit Fee Paid 3 a O Park Dedication
ISSUED BY_________ Date S77t/ Final /O.P.
In the performan� of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 0 y
AGENT /OWNER DATE
ADDRESS gSV f P 'i L- jelF .235 6 g5
TELEPHONE
LING PElNrx APPLICATION "7/ �i9
/3 sue/ G7/ DA '7// S� PERMIT#
OWNER A PLVlBlER
mat= of won AL-Cr
NEW RELAT REPAIR INTERIOR
SAN SEw Ke J L di
W R Bathtub Su Pu
Ejector
STORM
SEW '7
Toilet Water Softener
INSPECTION INSPECYION DATE Kit. Sink Drinking Fountain
Sink(other) TTrinal
Waterheater Slop Sink
C --e.CZ1- e 't-- r2 c Shower Grease Trap
Floor Drain Local Waste
Laundry Tub Site Drain
�Disposal Laundry Standpipe
.Dishwasher Catch Basin
Violation notes on the reverse side!