HomeMy WebLinkAbout0007774-Plumbing (laterals) CITY OF OSHKOSH N° 07774
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG 0, SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS Z_ 4 ZI PLAN NO.
OWNER 6-....._--C cti- V A � d�< •
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 o �� ze
BT WH Disp WSoft CBasin
— Sh DW `
Lav DF San. Sewer �, ���,
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water � !�r Cfit -G.—
Other
, ._.5 --- laY/2 , N ites/axa /ZZ4 .
FEES: Valuation $ 5--- a'i.__- Permit Fee Paid $ _ Park Dedication $
ISSUED BY 7/z—'' -° Date' Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE •i ce I/ _ _
...r
f
AGENT /OWNER
DATE
ADDRESS
TELEPHONE #
ppyMBIpIGIERMIT APPLICATION
ADDRESS 74 o 5C17 /6(241- 700", DATE 46//g-7-4( PERMIT# 0772
OWNER PLUMBER j�l 5 ,c�c. .4,'-e
NATURE OF WORK �c
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER Bathtub Catch Basin
STORM SEW, 1 Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
`/A /IV, Shower Laundry Stand Pipe
/� C "-rv` Floor Drain Laundry Tray
L Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
P** Violation notes on the reverse side{