HomeMy WebLinkAbout0033875-Plumbing (laterals) 6 o/
CITY OF OSHKOSH N2 33875
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG Af SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS ' g 7/ ��'( P PLAN NO.
6-a.,L....?a- /
OWNER
DESIGNER
USE /NATURE OF WORK /V S F
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 E7,4_,..P E_
BT WH Disp WSoft CBasin
Lav Sh DW DF /' San. Sewer f P ti C
WC FDr SP Ur / Storm Sewer V-Pi C
Sink LTub Eject SS Water
Other
FEES: Valuation $ / a 0 0 • d d Permit Fee Paid 3 ®, d 0 /
$ Park Dedication $
ISSUED BY Date ./ X 7--- Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE ,/z ■ C ) - q.3
AGENT /OWNER 5.— /
DATE
ADDRESS '') . i■ ' "''` gi , , i . • . 2g -/
TELEPHONE #
X
DI�ID
PERMIT APPLICATION
ADDRESS ff 7/. /� DATE 73 PERKET# . 3 g.
OWNER ' - i E
NATURE or WORK ,, /1/--C
- a A ,r n 1 _ /
N T� RELAY REPAIR era Y'
SAN SES.T x tic i is
W /l, Bathtub
$TORN SECT 4 '1 — Sump Pump
Lavato E'ector
Toilet Water Softener
INSPECTION DATE INSPECTION DATE Kit. Sink , Drinking Fountain
Sink(other)
:S/W/57 Urinal
S 9//y 3 Waterheater Slop Sink
ower ease Tr
Floor Drain Local Waste
Laundry Tub Site Drain
Disposal Laundry Standpipe
Dishwasher Catch Basin
** Violation notes on the reverse side]