HomeMy WebLinkAbout0012063-Plumbing (laterals) CITY OF OSHKOSH No 1
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG 0.. SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS °? c /c? / %'lam[ OL'1 %' ti1_. _ PLAN NO.
OWNER c.�c; 4 I rf <1
DESIGNER
USE /NATURE OF WORK �;� , Q Y!//ti S -y� , � �.v, z GZ h'f p/ C �i 4--- �'Pr�4�/l e .
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 S J �Y/� >�• c �ric�c�.
BT WH Disp WSoft CBasin �/
Lav Sh DW DF / San. Sewer q f �(! C-
WC FDr SP Ur ( Storm Sewer / t G / 4 " C
Sink LTub Eject SS T Water / eCip ' e--
Other /
�
FEES: Valuation $ - T f Permit Fee Paid $ .b V Park Dedication $
ISSUED BY - 7-- 21y Date / — 5- - 'T Final /O.P. /Os - 5—.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction. /f
SIGNATURE p z,.. f r ----,'''-/--<'*-- sue. .
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
�� /� / � r� P 1: ING PERMIT APPLIC
ADDRESS DATE l U � �
PERM/T# _ /-
OWNER ....0 ■ %..■ '• . /41.-A.-.4... PLUMBER V Q h
NATURE OF WORE : J o2 S .
/ NEW RELAY REPAIR INTERIOR
L
SAN SEW 7 °
WATER #
M Bathtub # catch Basin
STORM SEW ' Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Rita Sink Local Waste
Sink(other) Site Drain
Shower Laundry Stand Pipe
/o/ �!�( 71 "/4//
c /' Floor Drain Disposal Laundry Tray
Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
.Urinals _ Future outlets
•
I** Violation notes on the reverse side]