HomeMy WebLinkAbout0020162-Plumbing (laterals) CITY OF OSHKOSH N2 20162
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG A( SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /�S / �� PLAN NO.
OWNER V „L._
DESIGNER
USE /NATURE OF WORK S �— '"-`�
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
r'..
PLUMBING CONTRACTOR _______ ____ez
- BT WH Disp W oft CBasin ct
_Lay Sh DW DF / San. Sewer / 9J C
WC FDr SP Ur / Storm Sewer K 4 t C
- Sink LTub Eject SS L /
Water ` ac-t_
Other
FEES: / Valuation C/ -� Permit Fee Paid $ ° ' O cs Park Dedication $. n ir
ISSUED BY Date a -- d` 5 —94 Final /O.P. ' 7 0 — /v
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
/ __.
SIGNATURE '
GENT /0 ', ER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS _4 Z / _ DATE -0 PE ' T# °2 a /6 .Z-
OWNER 1 _ FI__ • PLUMBER � ��, ,
. _ .,
NATURE WORK _ .5� , ,., - Q.,. '
NEW RELA REPA R INTERIOR
SAN SEW > # #
WATER / " ( 1 0 %-t. Bathtub Catch Basin
STORM SEW "c Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other)
wer Site Drain
S f d 7/2 '7 Shower Laundry Stand Pipe
a
/ 8 / Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
f Violation notes on the reverse sidel