HomeMy WebLinkAbout0025963-Plumbing (laterals) CITY OF OSHKOSH N9 25963
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG A(J SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /l5---0 40 O PLAN NO.
OWNER ✓eaD
DESIGNER p
USE /NATURE OF WORK 'y42t.c> 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 W / t`4 00 4 IS
BT WH Disp WSoft CBasin
P ve,
Lav Sh DW DF 7 San. Sewer
WC FDr SP Ur " Storm Sewer Po e-
Sink LTub Eject SS / Water C u
Other
FEES: Valuation $ /6 be) 'ro 2
Permit Fee Paid $ Park Dedication $
ISSUED BY Date / O °) 3° V Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .Z'/ ( -2 '7/e��' S " 6 13 ? s 4).;22-9/
AGENT /OWNER DATE
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ADDRESS ( -s7JJ s d. 4 6 j p� ; S'T- 4 "? 4
TELEPHONE #
PLUMING PERMIT APPLICATION
ADDRESS / /S ri LA, DATE 9 - oz 6 ~7/ P RMIT# a �3
OWNER 6- 6---'445 4 P E C
NATURE OF WORK 41.-a-G-J _ ,
NEW RELAY REPAIR INTERIOR
SAN SEW [VAJ # #
WATER `/ e-� Bathtub Catch Basin
STORM SEW! «#L)- . Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
S o wer her) Site Drain
�j GJ /d Sink(other)
h er Laundry Stand Pipe
Floor Drain Laundry Tray
Disposal. Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
,Urinals Future outlets
I** Violation notes on the reverse side]