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HomeMy WebLinkAbout0027195-Plumbing (laterals) � CITY OF OSHKOSH N° 27195 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG �] SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - -�� - - - - - - - - - - - - - - - - ADDRESS � o �d � � � � � �� PLAN NO. OWNER � �`��" - ` DESIGNER . USElNATURE OF WORK �� -S �^^ � � � BUILDING CONT�RACTOR 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 ` G PLUMBING CONTRACTOR �� � BT —WH —Disp —WSoft —CBasin _Lav —Sh —DW —DF �San. Sewer �� J � . —WC —FDr —SP —Ur —Storm Sewer —Sink —LTub —Eject SS �Water f � Other FEES: Valuation $ � �� • � �� Permit Fee Paid $ `� � � � d Park Dedication $ ISSUED BY � ^ Date Z � '� � �Z Final/O.P. �� -/1-q/ In the performance of this work I agree to perform all work pursuant to rules governing the described construction. , � /�' SIGNATURE -�� L` � �� ( � . AGEN R DATE �� ADDRESS : TELEPHONE# PLIIi�ING PERMIT APPLICATION ADDRESS `� 8 7 G Gv , `�' e��'� � -� � — � DATE / //" g/ PERMIT# � �/S 5 aWNER � � —e.`w P III�IDER -�a�. NATURE OF WORK /(��� S r� � C� �-�, 2� �, NEf1 RELAY REPAIR INTERIOR � �j �� , AN SEW ,�v'C �, � WATER Bathtub 6atch Basin ' Lavato Grease Trap ; Toilet g p INSPECTION DATE INSPECTION DATE Rit. Sink Local Waste / Sink(other S( � , � // ��Ter LauadrqaS taad Pipe , j F oor Drain Laund Tr . Dis osal Wat. Softner Dishwasher D. Fountaia ' Water Heater E�ector Future outlets ** �� ot o the reverse side