HomeMy WebLinkAbout0037615-Plumbing (laterals) CITY OF OSHKOSH
N2 37615
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG J SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS - "° / � ` �/ PLAN NO.
l ir 6;,-,/,,,L OWNER
DESIGNER ,A/ �/ /
USE /NATURE OF WORK /1/E — 0 - -� /
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 ir d
BT WH Disp WSoft
CBasin �p_______
— Lav _ Sh DW DF San. Sewer (,L WC FDr SP Ur 1 Storm Sewer ` C
Sink _ LTub Eject SS /C.-tti
Water
Other
��dC?, d ✓
FEES: Valuation $ Permit Fee Paid $ gV,',f Q0 0 Park Dedication $
ISSUED BY Date / ' Fina l /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE \ _.G
7«
AGENT /OWNER
/" � q DATE
ADDRESS i ' t.-- ! ,// - l/v A4r.4r�, .e., e' _(mil , " SJ'� gfei7c--
TELEPHONE #
I1 INC PEREIT APPLICATION 6/. ADDRESS 3 • r � , . . / lei/ _ DATE -/
OWNER .. _.� 1 . ! P ERI'Q ?# �'��rr
���. , i
PLDl�ER • _.
NATURE OF WORE .:v:►'�:!,.� 4s7`_ op�' f __ i I i �-' ,/
NEW RELAY REPAIR INTERIOR '�
�r ���� /
WATER
• ; a � - - � Bathtub
- -_ Sum. Pu
1-. .. ON DATE � Ejector
INSPECTION DATE - . Water Softener
= Sink(other = Drinkin• Fountain
MMMMIIIIIIIIIENINNI
S1o. Sink
MI Floor Drain a -se Tra.
Laundry Tu. Local Waste
In Dis•osal Site Drain
IIII Dishwasher Catch Stand.i.e
Catch Basin
.! i' a id