HomeMy WebLinkAbout0026330-Plumbing (laterals) CITY OF OSHKOSH N2 26330
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG K SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /1 C 4- 4 L PLAN NO.
OWNER G I l _ c
DESIGNER
-c■t—e:et //e/--
USE /NATURE OF WORK --s g f R --- CD -"
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 d 'erki e;O
BT WH Disp WSoft CBasin
Lav Sh DW DF C San. Sewer c IP u C
- WC FDr SP Ur .L Storm Sewer V / U C
- Sink LTub Eject SS Water / e....-,.—
Other
FEES: Valuation $ 2 S — a - d c3 Permit Fee Paid $ o ` a 0 Park Dedication $
ISSUED BY L Date l—
_ 9 / Final /O.P. // -/f -4 i
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE e _ _ _ / (- zi f(
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS S� = /'1_ i ,' - ! DATE /I . �`� / 3— PERMIT1k -) 6 3 c
OWNER . ` , / PL ER _ -,
MATURE OF WORK /f 1. -c.) .SJ _ 0 ; 6
NEW RELAY REPAIR INTERIOR
SAN SEW Vii C
WATER /
Uf Bathtub Catch Basin
STORM SEW
Lavato,► Grease Trap
Toilet 1 Sump Pump
INSPECTION DATE
INSPECTION DATE Kit. Sink Local Waste
S 7‘0/ST S,2_,<) /7 / 5 Sink(other) Shower Site Drain
Laundry Stand Pipe
Floor Drain Laundry Tray
err- Disposal Wat. Softner
..ecfc-o- Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
f** Violation notes on the reverse side]