HomeMy WebLinkAbout0030076-Plumbing (laterals) CITY OF OSHKOSH N°_ 30076
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG [J 1 SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS :to S PLAN NO.
OWNER
DESIGNER _ � _...��L3-
USE /NATURE OF WORK S F R f t_.,e,i
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 y Cy - --
BT WH Disp WSoft CBasin
Lav Sh DW DF t San. Sewer Yell/ c
WC FDr SP Ur 1 Storm Sewer K U v
Sink LTub Eject SS _L Water / 4 -.__
Other
FEES: Valuation $ / >46 O - O ° Permit Fee Paid $ -3 6 ' 6 O Park Dedication $
ISSUED BY Date "/� 2- Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE -'(r� — la --p
�/� AGENT /OWNER DATE
° I
ADDRESS ` _e__ ¶C -P �i7
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS. �� DATE 7 /- z -/7- - RNIT# c�7
OWNER G PLUMBER
NATURE Or WORK ,t) FR Q
NEW RELAY REPAIR INTERIOR
SAN SEW NC- - # #
WATER Lac- Bathtub Sump Pump
• ; A. ' VC Laysto E' ector
Toilet Water Softener
INSPECTION DATE INSPECTION DATE Kit. Sink Drinking Fountain
Sink(other) , Urinal
3/ &.J/Sr $ 7/ Z , , Waterheater Slop Sink
,Shower Grease Trap
Floor Drain Local Waste
Laundry Tub Site Drain
Disposal Laundry Standpipe
,Dishwasher Catch Basin
** Violation notes on the reverse sidel