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HomeMy WebLinkAbout0019933-Plumbing (laterals) � CITY OF OSHKOSH N° 19933 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG� SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - : ADDRESS ���� �c Y l� S i�/e PLAN NO. OWNER �� �'� �O'C' i/�P r DESIGNER USE/NATURE OF WORK � �� S BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEA�ING 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 PWMBING CONTRACTOR fL-`/ T� � C_ � —BT —WH —Disp WSoft —CBasin —Lav Sh —DW —DF �San. Sewer � Y D�� —WC —FDr _SP Ur � Storm Sewer � , � � G ' _Sink —LTub —Eject —SS �Water �I� C'-� Other FEES: Valuation $ �5�� •a� Permit Fee Paid $ 3 �� av Park Dedication $ ISSUED BY � � Date � 'l3 " 9v Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. : �' ` SIGNATURE `� �� ��� S� �'� � S— �"`-��5"" ,c AGENT/OWNER DATE � ADDRESS TELEPHONE# � PLUMBING PERMIT APPLICATION ADDRESS �S �S 1 DATE $ J3 -�v ERMIT �k /973� OWNE R P LUI�BE R NATURE OF WORK s•-��—/� . NEW RELAY REPAIR INTERIOR SAN SEW yG ,• �k �6 WATER . " athtub eatch Basin STORM SEW ' tlC avator Grease Tra Toilet Sump Pump INSPECTION DATE INSPECTION DATE Kit Sink Local Waste Sink(other) Site Drain Shower Laundry Stan pipe Floor Drain Laundry Tray Disposal Wat. Softner Dishwasher D. Fountain Wa.t�r Heater Ejector Urinals Future outlets ** Violation notes on reverse side