HomeMy WebLinkAbout0019062-Plumbing (laterals) (4)..) CITY OF OSHKOSH N9 19062
- PERMIT APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG , 18:1 SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS X83(, L-, % PLAN NO.
OWNER E -si:
DESIGNER
USE /NATURE OF WORK_( S ei.1.-1['.r- 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 /(77// 6i, 7
KC7
BT WH Disp WSoft CBasin
Lav _ Sh DW DF (San. Sewer 4 `7 li , 2 --
WC FDr SP Ur / Storm Sewer ett/�L-
Sink LTub Eject SS Water / C,.
Other
f� c>v ✓
FEES: Valuation $ /�3 Permit Fee Paid $ . 3d Park Dedication $
ISSUED BY C./ --7,„.."' Date g,/2.2 4 ) Final /O.P. d 15
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ... Vt.-el ` $Zv 7 ''/G S ?7,,) C— K -- c.O
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
p �jJ PLUMBING PERMIT APPLICATION
ADDRESS o j �/7C C" DATE Z -z/-T PERMIT# 1
OWNER s-"eali/ PLUMBER , ��'
NATURE OF WORK SP/.c/ d L.1
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER / " Bathtub Catch Basin
STORM SEW, di' Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste
Sink(other) Site Drain
Shower Laundry Stand Pipe
Floor Drain Laundry Tray
j /1` /� Disposal Wat. Softner
l ll Dishwasher D. Fountain
Water Heater Ejector
.Urinals Future outlets
f** Violation notes on the reverse sidel