HomeMy WebLinkAbout0012066-Plumbing (laterals) CITY OF OSHKOSH No 1
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG$ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS � / 7 +--L ` PLAN NO.
OWNER- s"�'/P� ---- �— /d ,•L
DESIGNER
USE /NATURE OF WORK t� .� E . 4.._ 4 Z
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 ./v J--t �. -c,--
BT _ WH Disp WSoft CBasin �/
Lav Sh DW DF 4 San. Sewer -7` / `��-
14 r
WC FDr SP Ur /Storm Sewer j
Sink LTub Eject SS /
Water /
/. /or� -e.._.
Other lY� cre /
FEES: Valuation $ 'S �� Permit Fee Paid $ —() Park Dedication $
ISSUED BY G y„,." ---- Date / `S-" `y Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE pL g
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
/f� P�UMBING PERMIT APPLICAT N
ADDRESS .0 ,02/6$ i�"�a1 L ' DATE �l ( PERMIT# liz��C
OWNER !•. ' .. -. i PLUMBER /v��
NATURE OF WORK Sc R -4-
NEW RELAY REPAIR INTERIOR
SAN SEW #
WATER
Bathtub Catch Basin
STORM SEW Lavator Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
CA/ r E./ 11i`Se Shower Laundry Stand Pipe
cdY Floor Drain Laundry Tray
Disposal Wat. Softner
Lb t Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
1** Violation notes on the reverse sidel