HomeMy WebLinkAbout0042857-Plumbing (laterals) CITY OF OSHKOSH N° 42857
41 PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG k SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / . /6 • ' PLAN NO.
OWNER S' cc- ,
DESIGNER
USE/NATURE OF WORK '
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 tS Z ice -2-
_ BT _ WH _ Disp — WSoft _ CBasin
Lav _ Sh _ DW — DF _ San. Sewer / J
— WC _ FDr _ SP _ Ur Storm Sewer U Y C-
____ Sink _ LTub _ Eject SS — Water
Other
FEES: Valuation $ 7Z$ t ° Permit Fee Paid $ /0 . 0 d I Park Dedication $
ISSUED BY Date l /r-� —2 SC Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
r E 4 Ortz-1/4_4. 1 • °(k
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION
ADDRESS 4i ,, ���_ - 3 7 DATE . 9 / 7 / V OWNER - PERMIT# . �-
NATURE OF WORE A i ,'
; :.4 : G
1 REPAIR INTERIOR
WATER � #
I. ; Y ,� 1ir�- Bathtub Sum.
Lavato E'ector
. INSPECTION e let Water Softener
DATE Kit. Sink Drinkin. Fountain
/� I 'C� p/� n „ Sink other
V e I /9-- „ P W. a e. to Slo. Sink
'• e_se Tra•
Floor Drain Local Waste
9 /,,2 Laundry Tu.
�9 Site Drain
!!! Dis.osal Laundr Stand.i.e
Dishwasher Catch Basin
• •1. . .. i -