HomeMy WebLinkAbout0041762-Plumbing (laterals) K°7
CITY OF OSHKOSH N 41762
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG IP SIGN ZONING FLOOD PLAIN HEIGHT
a
ADDRESS 1 fl/
PLAN NO.
OWNER ..........1.s....6
DESIGNER
e 4Z x
USE /NATURE OF WORK 1/ S 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 Y1°1 DF San. Sewer C
A
WC FDr SP Ur 1 Storm Sewer r v C–
Sink LTub Eject SS Water
Other
FEES: Valuation /'S'4 d O p
S Permit Fee Paid Ke"-- Pa rk Dedication
ISSUED BY� Date Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE e/ 9 -.2/- 7f
Q� -�f ,'e
f AGENT /OWNER DATE
ADDRESS ;o Ole 1.:1,t. 4c""- S— c� v.-a
TELEPHONE
DMBINC PERMIT APPLICATION
ADDRESS g; DATE 9 s PERMIT# T /2C 2
owNER PL�ER ,6Z---/,___fr-z_,,,t__
NATURE 07 WORK --C/ 4—
NEW RELAY REPAIR INTERIO:
SAN SEW ®I C-
WATER V;a.2.-- Bathtub
STORM SEW. Lavatory Ej ector�
Toilet Water Softener
ON DATE INSPECTION DATE Kit. Sink Drinkin Fountain
Sink(other) TTrina1
w/v Waterheater Slop Sink
Shower Grease Trap
Floor Drain Local Waste
Laundry Tub Site Drain
Disposal Laundry Standpipe
4—....... Dishwasher Catch Basin
Violation notes on the reverse side