HomeMy WebLinkAbout0016376-Plumbing (laterals) CITY OF OSHKOSH N°_ 16376
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG% SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ?(? Lri-Or) (-favr.7 PLAN NO.
OWNER ✓__ Ar.ed d
DESIGNER /
USE /NATURE OF WORK et-- GI/I.t L.4../4,4 / 70,v -.,( /i, ' dt:/tr),- ' _
/(f� /M / t.JI f
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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 g _
BT WH Disp WSoft CBasin ,./
G
Lav Sh DW DF / San. Sewer 7' "
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS J Water / b lr
Other
FEES: Valuation $ ‘ 367z Permit Fee Paid $ 402 Park Dedication $
ISSUED BY ,2/7J Date // 6 --£ Final /O.P. 4 /3/ /629
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE / le-- :------
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PE MIT APPLICATION
ADDRESS ( 2 . 57/ DATE if /tf - ff PERMIT # /
OWNER h PLUMBER �y Al
NATURE OF WORK -c-e-c_A-- .,--- C.t/et l en/1 i/I e c_ 1 Zi l' /
NEW RELAY REPAIR INTERIOR
SAN SEW 1 # # WATER / a Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE _ Kit Sink Local Waste
��2 s /lA Sink other) Site Drain
/ / Shower Laundry Stand pipe
Floor Drain Laundry Tray
/) /110 04.a.ti.,, via 0`-. se_4.✓U— Disposal Wat. Softner
Dishwasher D. Fountain
_ Water Heater Ejector
�d �3� /o- r Urinals Future outlets
I ** Violation notes on reverse side'