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HomeMy WebLinkAbout0027198-Plumbing (laterals) /� CITY OF OSHKOSH N° 27198 `' PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG�SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - � 8� o �,.� , �-o T� ADDRESS PLAN NO. OWNER ` � DESIGNER � �. - USE/NATURE OF WORK ��% �� � BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height , Foundation Class of Const. Occupancy Permit H�ATING CONTRACTOR Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR El�ctric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR —BT _WH _Disp WSoft —CBasin � —Lav —Sh _DW _DF �San. Sewer T� �� � —WC _FDr —SP —Ur —Storm Sewer —Sink _LTub _Eject —SS �Water l �- Other : FEES: Valuation $ /�� • � o Permit Fee Paid $ '��� � � Park Dedication $ i ISSUED BY � Date � � � F� Z Final/O.P. /�-l/- qi In the performance of this work I agree to perform all work pursuant to rules governing the described construction. 7 / ,..� SIGNATURE � ' G �� � � AGENT/O DATE � ADDRESS TELEPHONE 8 � PLtJ1�IDING PERMIT APPLICAIZON ADDRESS � �6�` �� • � C� � /�7z�- DATE /� - � /- y PERMIT# � ��9� 0'WNER �`G'�� PL ER NATURE OF WORR �.-Pt....� S�,� - C _�_ � 6fl�`� ' NET1 RELAY REPAIR INTERIOR � SAN SEW `��v�C � � WATER / Bathtub Catch Basin Lavato Grease Trav Toilet g p NSP CTION DATE INSPECTION DATE Rit. Sink Local Waste S�/� �� _ �� Sink(other Site Drain ��er Laundrq Stand Pipe , ' Floor Drain Laund Tr `� Dis esal Wat. Softaer Dishwasher D. Fountain Water Heater E�ector Future outiets ** V' ot on the reverse side