HomeMy WebLinkAbout0003642-Plumbing (laterals) /CITY OF OSHKOSH N2 03642
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG g. SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS /33 4 Aere 4+- PLAN NO.
OWNER 4 z., 4. ,(
DESIGNER
USE /NATURE OF WORK ..5 gtic Lti Gi
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 i 1 P � / ( -. 4
- BT WH . Disp WSoft CBasin
/, �,
- Lav _ Sh DW DF San. Sewer �` j vG
- WC FDr SP Ur Storm Sewer
- Sink _ LTub Eject SS L Water ) 4 r� ,a�--
Other
FEES: Valuation $ )c� () Permit Fee Paid $ �7
Park Dedication $
ISSUED BY �/z./- Date �/i(7�'7 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
PR S
SIGNATUR ‘ -e-e-- Q '
E O 13 a c"' ���,'
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
PLUMBING PERMIT APPLICATION 6.30 5/..
PLUMBER . _ , 1 •1,11..4%. DATE a _ Y 7
NAME OF OWNER a- 3 ( 7 � � C.�'YC�Ip� -f
a/444/c, �, A DDRESS
,ivy°` 4 o
NEW SAN. WATER STORM 1 RELAY SAN. WATER STORM
Main to Curb Main to Curb
Curb to Bldg. Curb to Bldg.
Elect. Pumps Repair
Septic Tanks 1
NEW REP. NEW REP. NEW REP.
Bath Tub Gar. Disposal Catch Basin
Wash Basin Dishwasher Conductors _
Water Closet 4 Laundramats Grease C.B.
Sink Water Softener Sump Pump
Water Heater San. Bubblers Bar Wastes
Shower Bath Urinals Range Boiler
Floor Drain Dental Cuspidors Future Outlets