HomeMy WebLinkAbout0011532-Plumbing (laterals) CITY OF OSHKOSH No 11532
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ; SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 4 C 5447.4.."/Z., PLAN NO.
OWNER ez , L1_-
DESIGNER
USE /NATURE OF WORK d -- 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
PLUMBING CONTRACTOR ` `" l - 4;e4
BT WH Disp WSoft CBasin
Lay Sh DW DF _I San. San. Sewer '
- WC FDr SP Ur Storm Sewer Z-/"./aVe.
- Sink LTub Eject — SS .4. Water / " C erf-2i
Other
Grp
FEES: Valuation $ /`, Permit Fee Paid $ '''��- Park Dedication $
ISSUED BY �'�� Date 40 -/ Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ` J'z` � �5 0 3.? - 4? s' Q g
AGENT /OWNER DATE •
ADDRESS
TELEPHONE #
,. / _ P_LING PERMIT APPLICA N
ADDRESS 2 c j a4'p - _ DATE f4 cl PERMIT# 2
OWNER /��� /ems PLUMBER 47?7,
NATURE OF WORK sue■-t.,✓ d- SY-
NEW RELAY REPAIR INTERIOR
SAN SEW
WATER Bathtub # Catch Basin
Lavato • Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink
Local Waste
Sink(other) Site Drain
/ Shower Laundry Stand Pi
C z - W / U / p - �4 l�`ti Floor Drain Laundry Tray Pe
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
1 't - Future outlets
J Violation notes on the reverse side(