HomeMy WebLinkAbout0038545-Plumbing (laterals) N2 38545
CITY OF OSHKOSH
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 3 7 PLAN NO.
OWNER
DESIGNER
USE /NATURE OF WORK /VS i` d
BUILDING CONTRACTOR
Size Sq. Ft. Rooms Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat A/C Vent El Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 3/ Ls�
BT WH Disp WSoft CBasin
Lav Sh DW DF c
San. Sewer e t C
WC FDr SP Ur I Storm Sewer T// V C-
Sink LTub Eject SS Water
Other
FEES: Valuation `rf Q O 6 O' Permit Fee Paid 3 c3 C Park Dedication
/./V ISSUED BY Date Final /O.P. 2 `2. 9
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
S
SIGNATURE 7. 7 r
f.‘47)67 �O
AGENT/OWNER DATE
ADDRESS �!L �'z ^-1`4 Ci ly Q-- ,1-14'3 -9 7s,
TELEPHONE
INC PERMIT APPLICATION
ADDRESS 39 r DATE a S RIKIT# 3 .g�'-Y WralWAPIMIliallillr
OWNER I t f T.M.= a 1. ER
NATURE OF WORE f.�7 c) Sr i
NEW REL AY REPAIR N. OR
SAN SEW 1"" P k g- #r
WATER Bathtub
Sump Pump
STQRM SEW. V V\ it.. Lavatory Ejector
Toilet Water Softener
INSPECTION DATE INSPECTION DATE Kit. Sink
Drinking Fountain
S 2 V7Y Sink(other) Urinal
y 1 5 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(