HomeMy WebLinkAboutPlumbing (laterals) CITY OF OSHKOSH N° 20834
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ,kr SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / 6, // ` ` PLAN NO.
OWNER ��r
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 ,� ` / • / yu ,
r
BT WH Disp /WSoft CBasin
- Lav Sh DW DF / San. Sewer r r r'e J C
- WC FDr SP Ur Storm Sewer /
- Sink LTub Eject SS _L Water ( f
Other
FEES: Valuation $ 6 O . 3 m Permit Fee Paid $ ° 2C) ' 0 0 / Park Dedication $
ISSUED BY C C,c_alc_a Date IO`lJ /2l) Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Ilf SIGNATURE _ _ / 111' 60 Ally AGENT /OWNER 411. DATE
ADDRESS
TELEPHONE #
/6/7 Q PLUMB�I G PERMIT APPLICATION
',
ADDRESS L � 4 u.G� g - �\ ' / S<- DATE /t / 7 PE ' uIT# (2> 5 3fz
,
OWNER PLUMBER , ..;
NATURE OF WORK s,� ,-, // k)
NEW _ REL AY REPAIR INTERIOR
SAN SEW 1 Y PvG # #
WATER 1/ Bathtub Catch Basin
STORM SEW Lavator Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
�� ,t � - / -0 ( / / / Sink(other) Laundry Drain Stand Pipe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
4).L ji4eZ-e--,ses.O.Z.,c-c.,rel
( ** Violation notes on the reverse side!