HomeMy WebLinkAboutPlumbing (laterals) 4.) CITY OF OSHKOSH No 08249
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /(
e e75-=;:( PLAN NO.
OWNER M(,4 l
1
DESIGNER
USE /NATURE OF WORK
•
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
r
PLUMBING CONTRACTOR _ L_ _ 1�� _
BT WH Disp WSo / CBasin
Lav Sh DW DF 7/ San. Sewer
WC FDr SP Ur / Storm Sewer /
Sink LTub Eject SS Water ` ____
D
Other
FEES: Valuation $_ P it Fee Paid $ Park Dedication $
ISSUED Date —_ Vel/ Final /O.P. 3/
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 #
PLUMBIN 9ERMIT APPLICATION
ADDRESS / / ` ` (? - ..)51:/-e,_-„, // DATE .3/7 / PERMIT# z �
�A OWNER / 6 PLUMBER 2/2 tS
NATURE OF WORK S —
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER Bathtub Catch Basin
STORM SEW, Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
l� �6 Sink(other) Site Drain
S'icQ,v 3/7 /x, y-t■-ke,/ Shower Laundry Stand Pipe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
, Urinals Future outlets
1** Violation notes on the reverse sidel