HomeMy WebLinkAbout0009371-Plumbing (laterals) CITY OF OSHKOSH No 09371
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS °2 � /! �
" ®litC R,/ r PLAN NO.
OWNER 0 2 ‘tt C/ (- C
DESIGNER �J / . /
USE /NATURE OF WORK S�J C.A.) /I/ e . ia v L [ d ! `""-.,
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 C.- 1
BT WH Disp WSoft CBasin //
Lav Sh DW DF h" San. Sewer y '/
WC FDr SP Ur 'Storm Sewer �/
Sink LTub Eject SS `Water /
Other
FEES: Valuation $0° G V Permit Fee Paid $ — .5 ' o 0 Park Dedication $
Ailw ISSUED BY Date 7 . ; Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE Yr/t1(Z) 4S-62C°47
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
LS
PLUMB NG PERMIT APPLICATIION
ADDRESS& / olio � /�� (7 f PERMIT#
DATE ��_ �� IT�k
OWNER L!�1.r PLUMBER j 1% - LI 1 ,��r��,
I
NATURE OF WORK IL- ,,
NEW RELAY REPAIR INTERIOR
SAN SEW n
WATER # #
STORM SEW' K 1 Bathtub Catch Basin
101111,1=111111111111111.0 Grease Trap
INSPECTION DATE INSPECTION DATE Kit. Sink L uca P Waste
Waste
/n!cia Sink(other) Site Drain
Cd cv r j /i?r Shower
Laundry Stand Pipe
Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector
Urinals Future outlets
1** Violation notes on the reverse sidel