HomeMy WebLinkAbout0025515-Plumbing (laterals) CITY OF OSHKOSH N°_ 25515
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG AT SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS // / 0 .0 PLAN NO.
OWNER k .�_.
DESIGNER
USE /NATURE OF WORK /l./ -Q-u> -� r e - 0
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 / i ■
- BT WH Disp WSoft CBasin
Lav Sh DW DF 1' San. Sewer yP ✓ '
r�
WC FDr SP Ur t Storm Sewer r eV C
- Sink LTub Eject SS Water / 9
Other
900. Q d
FEES: Valuation $ Permit Fee Paid $ 3 6 Park Dedication $
ISSUED BY (.4 Date / — 2 7 - 9j Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE A - 9-.27-f(
[ ( •
AGENT /0' NER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS Ii/ Yd DATE gr PERMITd� ��
OWNER" PL ER /
NATURE OF WORK /a t.v - d i
NEW RELAY REPAIR INTERIOR f
SAN SEW f ®\ R- # 4k
WATER { / Bathtub Catch Basin
STORM SEW '( C--, Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Y Sink(other) Site Drain
ytu/s, , ' Shower Laundry Stand Pipe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
.Urinals _ Future outlets
r** Violation notes on the reverse side]