HomeMy WebLinkAbout0039700-Plumbing (laterals) X0/
CITY OF OSHKOSH
No 39700
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG, SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /®,a - 2 4/
'�� PLAN. NO
OWNER (/ety—c.,_ ,
DESIGNER
USE /NATURE OF WORK /1-S/ / a;
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 0 c ��
BT WH Disp WSoft CBasin
_Lay Sh DW DF / San. Sewer 7 (�
il C-
WC FDr SP Ur 1 Storm Sewer K 'tic
Sink LTub Eject SS _L Water f d
Other
FEES: Valuation $ 706 ° a Permit Fee Paid $ 3 6 • ° 6 I Park Dedication $
ISSUED BY Date r°' Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE emicp
AGEN NER DA
ADDRESS /7/f / - r 1 GI,OOC/ p/ /2‘_ Q 056
TELEPHONE #
o/
PLUMBING PERMIT APPLICATION
ADDRESS / / 9 r',� G,ei-nv�- DA bid- 9V PERMIT# .3, 0
OWNER l '. GAS Si G E5 - ,A ,: 13 / PLUMBER a x IAA i f.Y f
,
NATURE OF WORK 4 -S C _ _ d ! ___,
NEW RELAY REPAIR i r • RIOR
SAN SEW 4/" #
WATER 1" Bathtub Sump B1Bri SEW 5 Lavator9 Ej ecto
iii J
Toilet Water Softener
;NSPECTION DATE INSPECTION DATE, Kit. Sink Drinkin g Fountain
Sink(other) Urinal
Waterheater Slop Sink
Shower Grease Trap
,Floor Drain Local Waste
_ Laundry Tub Site Drain
v Disposal Laundry Standpipe
Dishwasher Catch Basin
** Violation notes on the reverse side(