HomeMy WebLinkAbout0039053-Plumbing (laterals) CITY OF OSHKOSH
No 39053
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG j J SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /ago C___ (:,e,.,/ PLAN NO.
OWNER an i
DESIGNER
USE /NATURE OF WORK /1/3
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 V C -------- �
- BT WH Disp WSoft CBasin /%v
Lav Sh DW DF r San. Sewer , 'J
- WC _ FDr _ SP _ Ur r Storm Sewer 474- 1I/ C
- Sink LTub _ Eject SS r Water /,...-,
Other
FEES: Valuation $ 70 d , 0 t0 • C� � �
�� Permit Fee Paid $ Park Dedication $
ISSUED BY G!/ Date 0 - 3/7N� Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 1fth. c -&-yAt 1�` c"
�� y / �
ADDRESS
AGEN i{gwNER ATE
�/
TELEPHONE #
Ya(
PLUMBING PERMIT APPLICATIO
ADDRESS, /a � 62- & - " , f. •c , DATE 0 15' PEmaT# 3 1 ' 6 3
OWNER , KPrr-- P.. ,-/I_ v 1,�
PLUMBER
NATURE OF WORK fftSA i
NEW RELAY REPAIR INTERIOR
SAN SEW Ylll C di. #
WATER -
Bathtub Su 1 • Pu 1
STORM SEW, 'U Lavatory Ejector
Toilet o
INSPECTION 42E INSPECTION DATE 1 Kii. Water
Sink Softener
Drinking ing Fountain
Sink(other) Urinal
� " / Waterheater Slop Sink
�� .mac ' Shower Grease Trap
{��'/ �J �/ 7.' Floor Drain Local Waste
Laundry Tub Site Drain
Disposal Laundry Standpipe
,Dishwasher Catch Basin
** Violation notes on the reverse side(