HomeMy WebLinkAbout0025969-Plumbing (laterals) 46) CITY OF OSHKOSH N° 25969
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG X SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS W--- ti- -t�l�'
PLAN NO.
OWNER if
DESIGNER J
Z Z /72____
USE /NATURE OF WORK 3 ie 0
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 Y P J c
WC FDr SP Ur 1 Storm Sewer 471 0 v C
Sink LTub Eject SS _4 Water -c-c__
Other
FEES: Valuation ®d G a Permit Fee Paid b d d V
Park Dedication
ISSUED BY Date !O 3- Final /O.P. /0 a r/
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE :del
Coe& �'j�e 3 2 4
AGENT/OWNER E
c1 DATE
ADDRESS S*--VsG 3 !O1 S~- -g"'j‘y
TELEPHONE
PLUMBING PERMIT APPLICATION
ADDRESS a g/a CL).'c 1 DATE 06 C E` p PERMIT# °2S '76, Q
OWNER k PL EA /I ry
NATURE OF WORK 64)."-------- -S F k. �L
NEW RELAY REPAIR INTERIOR
SAN SEW I Y 0v c
WATER Bathtub Catch Basin
STORM SEWI YPt/c Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
y4Lvf,-- Sink(other) Site Drain
Shower Laundry Stand Pipe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
,Urinals Future outlets
I** Violation notes on the reverse side]