HomeMy WebLinkAbout0011594-Plumbing (laterals) CITY OF OSHKOSH N9 11594
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ja SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS . 5I ,,'C ( .t1� 7 j PLAN NO.
OWNER (. . 6TY-75-(7. 4
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 t1/ -.S .0,7%' j 7
BT WH Disp _ WSoft " CBasin
__Lay _ Sh DW OF' /San. Sewer Y T L.-
WC — FDr SP Ur Storm Sewer
Sink LTub Eject SS Water � �" eppe."_—
Other " p
FEES: Valuation $ /oz Permit Fee Paid $ / ` Park Dedication
ISSUED BY ---".‘' Date /...q/7(W Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE e "..- " V'..-1--.6rji t' S
JA
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
/ PLUMBING PE'4 T APPLICATION
ADDRESS - ? 2. 6- ..f . . DATE I1 1 /3 /� p T# )I5 7
OWNER 37 t `j s! --
PLUMBER ) w' -2 r I` / be
NATURE OF WORK 5- , j
NEW RELAY REPAIR INTERIOR
SAN SEW
WATER #
STORM SEWI i Catch Basin
Lavato Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink
Local Waste
Sink(other) Site Drain
'.50 // lft ,,,,,4 7 - a .4 Shower Laundry Stand Pipe
5 61 (6 � / g /f Dispr aposal Wat. Softner
Di
� sl ry Tray
Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
I'ck Violation notes on the reverse side]