HomeMy WebLinkAbout0025832-Plumbign (laterals) CITY OF OSHKOSH N° 25832
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG 75 SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS
PLAN NO.
OWNER 4/ f
DESIGNER
USE /NATURE OF WORK ,- e s sti.
/ ,mil s , - _ Q.._
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 p Circuits
PLUMBING CONTRACTOR _O & v
BT _ WH Disp WSoft (...44k-- - CBasin
— Lav —Sh _DW DF 2 I J C
San. Sewer
- WC FDr — SP Ur
Storm Sewer
— Sink _ LTub _ Eject SS
Water
Other
FEES: Valuation $ /1-4 0 0 o - 0 d , Permit Fee Paid $ 4fO c a
ISSUED BY Park Dedication $
Date GZ► l � ' �/ Final /O.P. ff -$ - 4/
In the performance of i . work I agree to perform all work pursuant to rules governing the described construction.
SIGNATU -_ .l.r. T /` -' , % �
AGE /OWN // ` -/6-q/
Z-fd a ) DATE
ADDRESS � / (W
% TELEPHONE #
3�� (- , -6-, PLUMBING PERMIT APPLICATION
ADDRESS DATE c 3 2/ PERMIT# 2 s-8 3 � —
OWNER ,' / PLANER i .�« -
NATURE OF WORK ,ry4 < !/`. • - - ,� _ C
NEW REPAIR I ✓ RIOR //
SAN SEW P Pv e- I , # #
,WATER Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet I Sump Pump
INSPE TION DATE INSPECTION DATE Kit. Sink Local Waste
_ Sink(other) Site Drain
�`" Pipe
Shower Laundry Stand Pi
,/ g _ k, P
Floor Drain Laundry Tray
tr e- 7 Disposal Wat. Softner
Dishwasher D. Fountain
F i ^ I Water Heater Ejector
Urinals _ Future outlets
1** Violation notes on the reverse side]