HomeMy WebLinkAboutPlumbing (laterals) /CITY OF OSHKOSH N° 14771
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG 0., SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /6 Ke ,, PLAN NO.
OWNER Zef7 l �fe"ii___
DESIGNER
USE /NATURE OF WORK . Sr=_'i(�c/ �" w' CZ �ti
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 —___Li 5 C4-2,{�cf --, V
BT WH Disp WSoft CBasin
JJ
Lav Sh DW DF �L San. Sewer c( "OL/L --
WC FDr SP Ur Storm Sewer
r
Sink LTub Eject SS Water / c. ��r�P '^—
Other
.tea
d7.�
FEES: Valuation $ P ermit Fee Paid $ Park Dedication $
ISSUED BY s --_. Date eF - 7- /
Final /O.P. 6 *
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 #
PLUM,ING PERMIT APPLICATION
ADDRESS /z �/�it. -/Yl /I/ DATE - - -. ' 4 RMIT# ?
OWNER /' 1 C '^ GA-- PLUMBER vi., -- ;_.:_.- ,. .ii7r�1r".,- ;
NATURE OF WORK Ste IA J
NEW RELAY REPAIR INTERIOR
SAN SEW L{ ti
WATER i / 4 Bathtub Catch Basin
STORM SEW! Lavatory j Grease Trap
Toilet I Sump Pump
.INSPECTION DATE INSPECTION DATE Kit. Sink 1 Local Waste
Sink(other) Site Drain
11 ■ �J� fGiN 4/ VS Shower Laundry Stand Pipe
Floor Drain Laundry Tray
• Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
.urinals Future outlets
t** Violation pees on tl{e /verse side]