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HomeMy WebLinkAbout0022131-Plumbing (relay sewer) � _ CITY OF OSHKOSH N° 22131 PERMIT APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG � SIGN ❑ ZONING FLOOD PLAIN HEIGHT - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � � � PLAN NO. OWNER • �C=.�c�:.- DESIGNER 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 ELECTRIC CONTRACTOR Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits � PLUMBING CONTRACTOR S r �_ BT WH _Disp WSoft —CBasin —Lav _Sh DW _DF �San. Sewer � r � C —WC FDr _SP Ur —Storm Sewer —Sink _LTub —Eject SS Water Other l FEES: Valuation $ ���3 • � 4 Permit Fee Paid $ �� ' �' �� Park Dedication $ ISSUED BY �-J G��-�r�- Date � l� � Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described const�uction. SIGNATURE � AGEN WNER DATE ADDRESS TELEPHONE# - PLUMBING PERMIT APPLICATION ADDRESS J�� 7 DATE��`i/ PERMIT�k v�� / .S� OWNER � -�� PLU1��R ���z��-�����' NATURE OF WORK f .z.E=�r-� .��,y f .�i� .3�c�-a NEW RE REPAIR INTERIOR ' s�x sEw i��Pv� �k �k WATER Bathtub Eatch Basin � �^1 Lavator Grease Trap Toilet Sum Pum INSPECTION DATE INSPECTION DATE Kit. Sink Local Waste ,� , .,,� Sink(other) Site Drain `'��?�_.�' �� ,.�x��f Shower Laundry Stand Pipe � Floor Drain Laundr Tra Dis osal Wat. Softner Dishwasher D. Fountain Water Heater Ejector inals Future outlets ** Violation notes on the reverse side