HomeMy WebLinkAbout0020975-Plumbing (laterals) CITY OF OSHKOSH N°_ 20975
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBGM SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS //3 6 - ,_a._. — Z - a" PLAN NO.
OWNER . 0 ,_.42-.._
DESIGNER
USE /NATURE OF WORK S*-� �,c. ea-L - 42 �'tr2-"e) ' F
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 H 1/
BT WH Disp WSoft CBasin Gf �-
Lav Sh DW DF t San. Sewer
S`' r'Pt
WC FDr SP Ur Storm Sewer
V el C
Sink LTub Eject SS Water / "
Other
0 • 0 Z 0 ..0d. ✓
FEES: Valuation $ / O Q Permit Fee Paid $ / Park Dedication $
ISSUED BY C/ Date "// a/ '� Final /O.P. o '� b o
—
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMING PERMIT APPLICATION
ADDRESS 30 Z . -/
/ DATE 2 " -2g - - PERMIT # °
OWNER 4-.
l • •' _ PLUMBER ..c.-&..1-
NATURE OF WORK N I A; _ � '-'2- ` i
NEW RELAY REPAIR INTERIOR
SAN SEW = = ®
WATER / � � �
WA T E R SEW _ ;athtub
�r�- Catch Basin
-_� avator _ Grease Tra.
NSPECTION DATE INSPECTION DATE = Toilet Sump Pump
(,� -2 � ■Sink(other) _ Local Waste
41 `� � �� Site Drain
Shower Laundry tan• i e
R Floor Drain pip - Laundry Tray
q Disposal Wat. So tner
�/ 3 D D _ D. Fountain
Ejector
_ Future outlets
** Violation notes on reverse side