HomeMy WebLinkAbout0027065-Plumbing (water service repair) CITY OF OSHKOSH N2 27065
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 02 4 /4--t-
PLAN NO
OWNER 0 ./1
DESIGNER
USE /NATURE OF WORK w
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
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation Z o b a Permit Fee Paid 0 0 V Park Dedication
ISSUED BY t gee Date 2 7 2-
Final /O.P. 1 A' "q-
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
r 1
SIGNATURE 1 41
AGENT /OWNER DATE
ADDRESS
TELEPHONE
OWING PERMIT APPLICATION
AaaBESS DATE
OWNER 9 d s
A
o PLDffiE8 PERMIT#
NATURE OF WORE Z
NEW RELAY REPAIR RIOR
SAN SEW
WATER
T. ,R A. /cJ Bat Sump Puy
Lavato E' ecto r
INSPECTION Toilet Water Softener
DATE ,Eit. Sink Drinkin Q Fountain
Sink(other) Urinal
ilfee-t--4 F q 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 sidel