HomeMy WebLinkAbout0024595-Plumbing (laterals) CITY OF OSHKOSH N° 24595
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /#0 4 -- PLAN NO.
OWNER �c "4i.-z� i f -e-Gs t
DESIGNER
USE /NATURE OF WORK Z:6
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
r
PLUMBING CONTRACTOR
dJ
BT WH Disp WSoft CBasin
_Lay Sh DW DF 1 San. Sewer V d c
WC FDr SP Ur / Storm Sewer V Q v C `
Sink LTub Eject SS Water / C'--_—
Other
FEES: Valuation $ 70 O • O O Permit Fee Paid $ 3 0' o Park Dedication $
ISSUED BY t- Date 7 ` 3, `9/ Final /O.P. t - f - 9
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
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))-4-5---4- �- 7
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
/O �o 0 ( �^ - DATE f° ^ V 1-17r----;--,-/ r ,' 1 PERMIT # °? - S ^ �'S'` —
ADDRESS C �� 7L
OWNER
mac -� , / 'LUMBER
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/
NATURE OF WORK X)- .) S r
NEW RELAY REPAIR I
SAN SEW Y iivC. # # '
WATER / Cu. .Bathtub Catch Basin
STORM SEW genPLIc Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit Sink Local Waste
Sink(other) Site Drain
C j / ��ST Sp `S �� Shower Laundry Stand pipe
1 Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
on 0 1 Urinals Future outlets
I** Violation notes on reverse side