HomeMy WebLinkAbout0036991-Plumbing (laterals) CITY OF OSHKOSH N° 36991
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG gy SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS
PLAN NO.
OWNER tT • y
DESIGNER
USE /NATURE OF WORK N 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
BT WH Disp WSoft _ CBasin
Lav Sh DW DF ( San. Sewer T P
WC FDr SP Ur / Storm Sewer ° C"
Sink LTub Eject SS Water
Other
FEES: Valuation $ 1 / O O • a d Permit Fee Paid $ ° Park Dedication $
ISSUED BY Date r // V/CC--3 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ' ,'.e<'0 3 ?ate
�} AGENT /OWNER DATE
ADDRESS 6 re2- y 9. 4 C. 4C ga 44- 5" 57a-3 v 7S
TELEPHONE # •
4.14 /ae.ia c /
PLUMBING PERMIT APPLICATION l`
ADDRESS (2 Se) S CI-- , DATE 7/1 /93 PERMIT# - ‘Y5'1
A
OWNER . +5 h D A c+ e.t . , PLVHBER . l - ,
NATURE OF WORK I 1 ' ` "
NEW RELAY . IgtRIOR
SAN SEW
WATER #
Bathtub Sump Pu
STORM SEW Lavato,r 1 Ejector
Toilet -1 Water Softener
_t DATE IIYSPE ON DATE Kit. Sink
U 7 - ; - Drinking Fountain
i v Sink(other Urinal
,Waterheater Slop Sink
Shower Grease Trap
Floor Drain Local Waste
Laundry Tub Site Drain
Disposal Laundry Standpipe
-
„,Dishwasher I Catch Basin
** Violation notes on the reverse side(