HomeMy WebLinkAbout0006353-Plumbing (laterals) CITY OF OSHKOSH N2 06353
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG 1K SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS .0 - M . PLAN NO.
OWNER jS<e<C !/tn.
DESIGNER
I
USE /NATURE OF WORK ..� Q/L�p/ liCiGZ�
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 V e 1--1- 4..c, /mac
BT WH Disp 14Soft CBasin
Lav _ Sh DW DF San. Sewer y c ' (/c-
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water / fi We/
Other
FEES: Valuation $ 167 Permit Fee Paid $ / Park Dedication $
ISSUED BY Date /134 Final /O.P. 1 —17 —3 U
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE / / 6 s
AGE •WNER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS c2 75 — /1i ?C'� - DATE T,4€ ( 4 PERMIT# (3 <3
OWNER i��/L PLUMBER c ��� �t J
NATURE OF WORK - !Y`---
NEW RELAY REPAIR INTERIOR
SAN SEW # # i
WATER Bathtub - Catch Basin
STORM SEW Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
8'/ A7 /70„,-7 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!