HomeMy WebLinkAbout0002249-Plumbing (laterals) CITY OF OSHKOSH N9 02249
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG 64 SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS " n/ ,4( YI 7c* 4 PLAN NO.
OWNER ‘° i C:t A
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 / (Ni �ez�_
- BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer /vL-
WC FDr SP Ur Storm Sewer
- Sink LTub Eject SS Water / ‘ eIyc ----
Other
4!....----/
FEES: Valuation $ 7,3 _ ... Pe mit Fee Paid $ /) Park Dedication $
ISSUED BY_____________ –C Date /Z� /�' Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE C — / A
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMING PERMIT APPLICATION ∎ �.2._ S//
PLUMBER ,/� )S . �e- -� DATE /- 7/3/e7
NAME OF OWNER ‘ L ADDRESS dZ
NEW SAN. WATER _ STORM RELAY SAN. WATER STORM
Main to Curb Main to Curb
Curb to Bldg. Curb to Bldg.
Elect. Pumps Repair
Septic Tanks
NEW REP. _ NEW REP. NEW REP.
Bath Tub Gar. Disposal Catch Basin
Wash Basin Dishwasher Conductors
Water Closet Laundramats Grease C.B.
Sink Water Softener Sump Pump
Water Heater San. Bubblers Bar Wastes
Shower Bath Urinals Range Boiler
Floor Drain Dental Cuspidors Future Outlets