HomeMy WebLinkAbout0030971-Plumbing (laterals) CITY OF OSHKOSH N°_ 30971
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /73' 3 J e
PLAN NO.
OWNER C✓� / -'-
DESIGNER
USE /NATURE OF WORK N-4-a---&e, --1----E-7-.A.- e g_e_... 4 , c „..ca-,_--
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ NC ❑ 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 1 Storm Sewer L /"✓ C
— Sink — LTub Eject SS Water
Other
FEES: Valuation $ 4$'U 0 , a zi p a a
Permit Fee Paid $ , Park Dedication $
ISSUED BY PP Date 9 ----`°2 g. — 7 L Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ` , ►`
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
.PLUMBING PERMIT APPLICATION
ADDRESS S~ '" j DATE ? /l, / 22 Puma* . -o j 7/
.„,...s2 PLUMBER G
NATURE OF WGRIC ' ,, ,
y--
NEW RELAY REPAIR INTERIOR
:_
WA u- R
• ; A. T�l� Bathtub Sum. Pu 4
Lavato Ejector
TaAncTTON DATE INSPECTION Water Softener
2NSPECTION DATE , Kit. Sink
Drinking Fountain
Sink(other) Urinal
_
` - Ta 1 /13 fotAloci Waterheater Slop Sink
A ihstic s-;olewak Shower Grease Trap
Floor Drain Local Waste
' Laundry Tub Site Drain
Disposal Laundry Standpipe
.......... Catch Basin
** Violation notes on the reverse sidel