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HomeMy WebLinkAbout0021839-Plumbing (abandon sewer/water for raze) � CITY OF OSHKOSH N° 21839 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG � SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - -�.� - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS Z � � • � � .�c�'-- PLAN NO. OWNER �C`�� � � DESIGNER ,Q � , USE/NATURE OF WORK /� ��-- ���� 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 e ELECTRIC CONTRACTOR F�lectric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits � f 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 FEES: Valuation $_ f �.S o' '= 4 Permit Fee Paid $ « �� � � Park Dedication $ ISSUED BY W� Date ��"��x/2D Final/O.P.1�.(�/9�_ In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE , Z ,�� ..� AGENT DATE ADDRESS -� TELEPHONE# PLUMBING PERMIT APPLICATION ADDRESS �� 7� � � r� > DATE _ ���/1/ �v PE RMI T �� ��g,�� OWNER S�� PLUMBER ��r�- ��L�` NATURE OF WORK � S NEW RELAY REPAIR INTERIOR SAN SEW WATE R �� �� STORM SEW athtub , Catch Basin Lavator Grease Tra INSPECTION Toilet Sump Pump DATE INSPECTION DATE Kit Sink Local Waste �j N /�/j�/fCt1 Sink(other) Site Drain Shower Laundry Stand pipe Fioor Drain Laundry Tray Disposal Wat. Softner Dishwasher D. Fountain Water Heater Ejector Urinals Future outlets k* Violation notes on reverse side