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HomeMy WebLinkAbout0037614-Plumbing (laterals) CITY OF OSHKOSH N ° - 37614 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG K SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS 3 "a y' j • / - /� PLAN NO. OWNER G erie. c-�( " 1 DESIGNER USE /NATURE OF WORK -Cf " 0 --e--(- /--/--- 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 ______1( BT _ WH Disp WSoft CBasin - Lav _ Sh DW DF Vi ui r San. Sewer - WC FDr SP Ur / Storm Sewer K/ v - Sink _ LTub Eject SS Water Other FEES: Valuation $ L 45 Q n Permit Fee Paid $ 3 a G Park Dedication $ ISSUED BY S4Sez— Date 1 ././'' Final /O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE AGENT /OWNER DATE ADDRESS y' % �l 4 `j , e-- ,“.,-..r+«-, s. / , < 5 - P Ss TELEPHONE # � g , ING PERMIT APPLICATION �Ci ADDRESS, `, e n Y 6 DATE P - ( ` 4 3 PCT# . 3 � OWNER PLD�ER� C ERJ NATURE OF WORK ��= -= �.c%X. �S . !'; „IS - C} / NEW RELAY REPAIR INTERIOR • SEW Y ®v C- # # WATER ���ill Bathtub Sum. Pu A. IriZERI Lavato Ejector Toilet Water Softener INSPECTION DATE INSPECTION DATE Kit. Sink Drinking Fountain `t/e f �Sink(other) Urinal !/ Waterheater Slop Sink 7 Shower Grease Trap Floor Drain Local Waste Laundry Tub Site Drain Disposal Laundry Standpipe ..— 'Dishwasher Catch Basin ** Violation notes on the reverse side]