HomeMy WebLinkAbout0006354-Plumbing (laterals) CITY OF OSHKOSH N2 06354
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG y., SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS .26' /5 ./ ,0:• 1,--e_.....t PLAN NO.
OWNER ius �/`�
DESIGNER
USE /NATURE OF WORK -S -C_ -' cs..-1.---,..-V e--e.-"4„.4....--
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 C_,_ /I
BT WH Disp WSoft CBasin
Lav Sh DW DF / San. Sewer' t [ ' 7 L
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS _L Water / 4 c- G►--
Other
az.--/
FEES: Valuation $ Permit Fee Paid $ / 2 Park Dedication $
ISSUED BY Date l( / /� / 4 Final /O.P. 6 -4= -!?
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION z .
ADDRESS '( /'� // /
/ l�r�i�� DATE Q /mod'/ PERMIT# C)63 S `7
OWNER „ PLUMBER ciekkr CrrYl/1--
v
NATURE OF WORK �5,,,
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER Bathtub Catch Basin
STORM SEW _Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
a / S o wer her) Site Drain
(� .�& 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!