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HomeMy WebLinkAbout0021546-Plumbing (cap laterals for raze)t }� /� CITY OF OSHKOSH N°_ 21546 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG � SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - �3u-cr�o �- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS /y' � -� �✓ � PLAN NO. OWNER ��L.� DESIGNER USE/NATURE OF WORK -- c:�-�-rf �����- �� ' � 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 c Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits 1 PLUMBING CONTRACTOR BT _WH _Disp WSoft _CBasin � _Lav —Sh _DW _DF —San. Sewer —WC FDr SP Ur Storm Sewer —Sink _LTub Eject —SS _Water Other O, G O FEES: Valuation $ 7�� �' Permit Fee Paid $ � Park Dedication $ ISSUED BY � > Date lr � � �� Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE ������'C.�. ����"`�� AGENT/OWNER DATE ADDRESS TELEPHONE# PL ING PERMIT APPLICATION '" ADDRE S S � 3 3 ������ DATE � �` /C - �� E RMI T�� �%S��.E� OWNE R ��Ct J p �^R ' �l G-7_ NATURE OF WORK ��- /�-QZ-�.-e.-�. ,�� ,.r� � , NEW RELAY REPAIR INTERIOR SAN SEW �� �k WATER Bathtub Catch Basin �M S� Lavator Grease Trap Toilet Sum Pum INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste ^ / Sink(other) Site Drain �!�( � - �6 -��j Shower Laundry S tand Pipe � � Floor Drain Laundr Tra Dis osal Wat. Softner Dishwasher D. Fountain Water Heater Ejector rinals Future outlets ** Violation notes on the reverse side �