HomeMy WebLinkAbout0030077-Plumbing (repair sanitary sewer) CITY OF OSHKOSH N ° - 30077
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /. 6 PLAN NO.
OWNER _ -
DESIGNER
USE /NATURE OF WORK , _cy--r-e.-- ,-.1 ._.-e------r---c-
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 '¢iz.
- Lav Sh DW DF — San. Sewer
- WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ Permit Fee Paid $ / 0 ' Park Dedication $
ISSUED BY Date // /'7 Z Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE '. >� (I26 f /� ` CU--°
AGENT /OWNER DATE
ADDRESS S 4,s"` GT
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS ICO i �' - , DATE . �'2- S 9z- FERN# . a ° 77
. PLUMBER
OWNER .
NATURE 07 WORK 1 , g
NEW L AY REPAIR INTERIOR
SAN SEW 1 \LC. # #
WATER Bathtub Sump Punip
STORM SEW. Lavator9 Ejector
Toilet Water Softener
INSPECTION DATE INSPECTION DATE Kit. Sink Drinking Fountain
_ Sink(other) Urinal
C,-,----9, � 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 side(