HomeMy WebLinkAbout0011531-Plumbing (laterals) CITY OF OSHKOSH N2 11531
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBGSIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS c
- i - 4., _ PLAN NO.
OWNER � �./G�G igti...--
DESIGNER
USE /NATURE OF WORK T�..E — . _ , _ At.... . or, L-1..--....
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 _ -Q �L cvi.T
BT WH Disp WSoft CBasin // yD YG
Lav Sh DW DF L San. Sewer (` �v
WC FDr SP Ur ( Storm Sewer 7�wC
Sink LTub Eject SS / Water l Corm~ -
Other
FEES: Valuation $ / 7 Permit Fee Paid $ c ( Park Dedication $
ISSUED BY Date 7 he Final /O.P. //` 27 ` 81
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE A e 0-e-a/4 Pl/°.P.S' a 2 3 a-6 /o?— ,"2
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS / y / 3 S� 4 t DATE /2/25;/re PERMIT# /1573/
OWNER / P _P cA PLUMBER ,
NATURE OF WORK y S - Cd r --«/ ,,Si
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
Sink(other) Site Drain
Shower Laundry Stand Pipe
Floor Drain Laundry Tray
/211 Disposal Wat. Softner
n Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
I** Violation notes on the reverse sidel