HomeMy WebLinkAbout0007371-Plumbing (laterals) 4101. CITY OF OSHKOSH N2 07371
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG,Q SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 4C3K .5 c ,,i I-2 -.-
PLAN NO.
�j /_
OWNER 70/7■ 5L-L k7�
DESIGNER
USE /NATURE OF WORK c_ref.c/ l
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 4"-iJ
BT WH Disp WSoft CBasin p
Lav Sh DW DF _L San. Sewer 1 ' VC-
WC FDr SP Ur Storm Sewer 1 !/
Sink LTub Eject SS Water '
Other
FEES: Valuation $ _ A Permit Fee Paid $ / Park Dedication $
ISSUED BY , 1� Date v0q4 Final /O.P. 3 - i Y - 8 tr
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
4
SIGNATURE - if 1 - �'I 1 r /� , 61` /of fis
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS - .v i /1 DATE (! f PERMIT# d 7i 7(
OWNER • /IA- PLUMBE /ice �.
NATURE OF WORK . . . 5 1 ? - - ( A ) 6.4 4/ 46..-.
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER IllUlaill Bathtub Catch Basin
ORM SEW r Lavator Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
�� Sink(other) Site Drain
`7�� / 7`;W 13//g5;61 Shower Laundry Stand Pipe
Floor Drain Laundry Tray
���� Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
tkle Violation notes on the reverse side]