HomeMy WebLinkAboutPlumbing (laterals) CITY OF OSHKOSH N2 08246
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBGji2r, SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 7''/ C fc-/ r" --- ' 1 4r i�e PLAN NO.
OWNER �Yr.0 Ce' le /- - J/
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
PLUMBING CONTRACTOR _ .IP. as _ t`;
BT WH Disp WSoft CBasin
G
Lav Sh DW DF /San. Sewer 7 /
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS i_ Water / G
Other
FEES: Valuation $ Per ' . Fee Paid $ / Park Dedication $ r
ISSUED BY O Date s���i Final /O.P. !/� $1/4k
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OW DATE
ADDRESS
TELEPHONE #
_ PL NG T APPLICAT
ADDRESS / A i� DATE , / 'C PERMI # _ (5•
OWNER Zfe c e 6PA--u,i7L PLUMBER ,�-( 4.., Cl- 4 .•
NATURE OF WORK c --`/
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
Sink (other) Site Drain
Shower Laundry Stand Pipe
itAf(-6 1 1;-- "Sr -C--c2 Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
j** Violation notes on the reverse sidel