HomeMy WebLinkAboutPlumbing (laterals) (11i) CITY OF OSHKOSH No 09374
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG El ❑ ZONING FLOOD PLAIN HEIGHT
/edge /7 ADDRESS 1? C `'t r , ma�yy,, 7 PLAN NO.
OWNER l._. L r ? S /9O " S
DESIGNER A /
USE /NATURE OF WORK s i5 / /...4.../ /(/ k Q u
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 N D 4w S Q w 2
BT WH Disp WSoft CBasin
_Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
✓
FEES: Valuation $ �p� do Permit Fee Paid $ ,..--040 -� - r Park Dedication $
ISSUED BY Date /�d Final /O.P. 7� ��'i
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE / af..5 24 -0 . 4. 1 2 ''''
pliki/
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
1‘ PLUMBING PERMIT APPLICATION
ADDRESS - .) , ! /fv li( ' 1., i // DATE 7/ /V / PERMIT#
OWNER
PLUMBER / f
NATURE OF WORK s.�t /
NEW RELAY REPAIR INTERIOR
SM SEW' icr #
WATER f 4 Bathtub Catch Basin
ITORM SEW ! Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
1�. - 7 /(34 Shower Laundry Stand Pipe / Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher 'D. Fountain
Water Heater Ejector
0)°°42-'. Urinals Future outlets
r** Violation notes on the reverse side]
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