HomeMy WebLinkAbout0102736 PCITY OF OSHKOSH
No102736
OSHKOSHPLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address3084 LAKE REST LNOwnerCreate Date06/06/2003
B MICHAEL SAMMONS ETAL
ContractorHOMEOWNERCategory410 - Residential-InteriorPlan
Bathtub0Shower1Ejector/Grind0Dip Well0F Prep Sink0Gar Drain0
Soda Disp0
Whirlpool0Floor Drain0Water Softner0Drink Ftn0Serv Sink0
Coffee Maker0
Lavatory1Lndry Tray1Local Waste0Wait. St.0Shamp Sink0
Int GreaseTrap0
Toilet1Lndry Stndp1Clothes Wshr0Ice Chest0Flr/Wst Sink0
Ext Grease Trap0
Res. Sink0Disposal0Bidet0Exam Sink0Catch Basin0
Bar Sink0Dishwasher00Wash Ftn0
Beer Tap0Sculry Sink
Water Heater0Sump Pump00Urinal0
Dent. Oper.0Hand Sink
Site Drain0Classrm Sink00Standp Rec0
Lab Sink0Plaster Sink
Roof Drain0Breakrm Sink00Ice Maker0
Sterilizer0Surgeons Sink
SFR/ Constructing a 14'x24' addition onto the existing house per the variance approved on 4/9/03. The addition will include a bathroom, bedroom,
Use/Nature
and closet. The addition will be a minimum of 2' above the flood level.
of Work
SizeMaterialType#Conn. Type
Storm Water0
0
0
0
0
Valuation$1,000.00Plan Approval$0.00Permit Fees$30.00
Issued ByDate07/09/2003
Permit Voided
The undersigned, in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the
principle residence of the undersigned, hereby acknowledges, per Wisconsin State Statutes, ss 145.06, that other individuals
will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing
the work involved must be covered by a permit issued to a properly licensed Master Plumber.
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
SignatureDate
Agent/Owner
Address522 W MURDOCK AVEOSHKOSHWI-2298Telephone Number
54901