HomeMy WebLinkAbout0030120-Plumbing (laterals) CITY OF OSHKOSH N9 30120
'111. PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 7 S s -c,-a D PLAN NO
OWNER —
DESIGNER
USE /NATURE OF WORK /t/..‹.,-. oe — 0�
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
i
PLUMBING CONTRACTOR i . -
BT WH Disp WSoft CBasin
i S‘
Lav Sh DW DF San. Sewer /1/ L
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water ( 4 '`
Other
FEES: Valuation $ 90 ' C , Q G Permit Fee Paid $ e) - 6 6 / Park Dedication $
ISSUED BY Pr Date / //q Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR O _ / / `1/
AGE NER DATE
L/
ADDRESS
TELEPHONE #
/ PL INC PER. cT APPLICATION 3o /- a
ADDRESS, a 7 ? S S � a-� 1, DATE // PE Ti, 400
— 5-...__ OWNER - 5-...__ ya,f PLUMBER
NATURE OF WORK
NEW RELAY REPAIR INTERIOR
SAN SEW q ki C
WATER i Bathtub #
r• ; 1. .4. Z. _= Su . Pu
Leveto E•ector
Toilet Water Softener
_+' 4 *re 'li ' INSPECTION DATE Kit. Sink
i � Drinkin. Fountain
T / / 4, /// f 2-- Sink other Urinal
Waterheater Slop Sink
Shower Grease Tran
Floor Drain Local Waste
Laundry Tub Site Drain
47 9- p D c',--° 1 f Disposal Laundry Standpipe
/
Dishwasher Catch Basin
** Violation not on the reverse side(