HomeMy WebLinkAbout0013165-Plumibng (laterals) CITY OF OSHKOSH No 1
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG0 SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS
azq 3 5 4 2... t < PLAN NO.
OWNER ��"L'z -r A £' ie 1
DESIGNER
USE /NATURE OF WORK 0. _ li _ C?'.. - _ r
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 _ , a__ Q.
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer , ` .e.--‘ WC FDr SP Ur 4_ Storm Sewer y /�C
Sink LTub Eject SS Water / � ,� etti-
Other
o-c) vv
FEES: Valuation $ /2Cr) Permit Fee Paid $ L) Park Dedication $
ISSUED BY ./ Date 3 /74 Final/O.P. -Z. v1
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE _ • �� -
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
ADDRESS /3) �LL2 DATEPLICATI �i, PG PERT OWNER - e -�� "� PLUMBER 7! 6,e!
NATURE OF WORK SGi(ic/ - G. ,2*to - 5
/A`� NEW RELAY REPAIR INTERIOR
SAN SEW `7 # #
WATER 1 1 _ Bathtub Catch Basin
STORM SEWI t{ " Lavatory Grease Trap
Toilet I Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink I Locai. Waste
Sink(other) ) Site Drain
�i S //� / Shower Laundry Stand Pipe
`''�` Z � Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
i ,urinals Future outlets
t** Violation pates on the reverse side{