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HomeMy WebLinkAbout0037784-Plumbing (laterals) 4 CITY OF OSHKOSH N 37784 PERMIT APPLICATION AND RECORD TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT ADDRESS 062 D W1 —I &IC/`- PLAN NO. OWNER IR buffil (.l Y� DESIGNER USE /NATURE OF WORK JF P (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 Wt fMAYA. BT WH Disp WSoft 4 CBasin 4 Lav Sh DW DF San. Sewer PU G WC FDr SP Ur Storm Sewer 4 C Sink LTub Eject SS Water /CC( Other FEES: Valuation 4 o. Permit Fee Paid Park Dedication ISSUED BY Date r(/ '0, Final /O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE r AGE •WNER DATE ADDRESS TELEPHONE 'MIRING PERMIT APPLICATION /34.0 W /i D A TE l i 3 PEBCT# 1 D 1 ADDRESS OWNER I:Eg NATURE OF WORE IV-C f ---/a--4 1 NEW RELAY REPAIR i I RIOR SAN SEW idc# WATER Bathtub Sump Pump STORM SEW 'L) C Lavatory Ejector Toilet Water Softener INSPECTION DATE INSPECTION DATE Kit. Sink Drinking Fountain Sink(other) urinal Waterheater Slop Sink 1'`-- ,Shower Grease Trap Floor Drain Local Waste Laundry Tub Site Drain Disposal Laundry Standpipe Dishwasher Catch Basin Violation notes on the reverse side(