HomeMy WebLinkAbout0106254-Plumbing � ` CITY OF OSHKOSH No � 5�
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ��` ���' 1
� ,
ON THE WATER '� � ,'
Job Address 1920 NEBRASKA ST Owner SHIRLEY GUSE Create Date�7JD2/2004
Contractor WATTERS PLUMBING Category 410-Residential-Interior Plan
Bathtub 1 Shower 0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 1 Lndry Tray 0 Local Waste 0 Wait.St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 1 Lndry Stndp 0 Clothes Wshr 0 Ice Chest
Res.Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Water Heater 0 Sump Pump 0 Dent.Oper. 0 Hand Sink 0 Urinal 0 Eye Wash Statn 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Steriiizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature FR/INSTALL BATHTUB, LAVATORY&TOILET
of Work
Size Material Type # Conn.Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
� Parcel Id#
� 1400820100
Valuation $7,594.00 Plan Approval $0.00 Permit Fees $21.00 ❑ Permit Voided�
Issued By /)'j< O Date 02/02/2004
In the performance of this work,I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address PO BOX 118 MENASHA WI 54952 -0118 Telephone Number 920-733-8125
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address,Permit Number,Type of
Inspection (i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
Ciry of Oshkosh �
Inspection$eryices Div�sion �
P O$ox1130 �
Os�:osh,WI 54903-1130
Phone; (920)236-SOS�
Fax:(920)236.,084 �1 K 1H
N N�WA7EF � �
Plumbing Permit Application
I heraby apply for a pemsic tq do and instalS the followin�plumbing on che preauses hereinafter described,rhe wock to conform co rb
�'�sconsin Stace Plumbing Code,in the pesformance of whieh all paroes.hereco agree m and ue bound by said statuces.
• Apptication(s)and fee(s)can be broug�t to City�-Iall,Room 205 or mailed to Inspection Services,Pp$ox 11'28,
Oshkosh WI 54903-1128. Commencing work without permit(s)will result in fees being doubled or$100,00 plus th�
normal petmit fee,which ever is greater.
OR
I ou are a r tor arttci oltn in the Ptrnrit Fee .lccou�t S��s�¢m and huve adeouate funds che�k h¢r
tf vou w[tnt thi.s proces.sed thratrnh votn- accoun� '
Job Address /��G7�/I��i��'yS (} ST Value(,n�iva�nr��randmateri�l5) �/�7T• Date /.�o�
Owaer S / u5� Cantractor �arr��s P�.K.��.��-
�Singl�Family �Duplex ❑'1Vlulti-Fannily ❑Rentat ❑Commercial []Industrial
Number of Fixtures:
$arhtub ,�L Lnd Swnd
rY p Denl.Oper. Shamp Sink _��,
�+hirlpool Aspacal Dip weil F1r/Wst Sint
Lavoia►Y � Dishwaxh¢r Drink Fm Catch Hssin
Toiiet I Sump Pump waii.Sa W�ISh FM
Res.Sink Ejec�or/Grind lce Chcss ��,,,�
Bar S►nk W�ter Softner Exam Sink Cwr Drain
W��r Heaur Local Wasce Sculry Sink Soda D�ap
.J G9S L L•1ECt�J P�VnI Clothcs Wshr Hand Sink Coffee Maker
Shower �idet F Prep Sink Ice Msker
�lo0r I7ruin Beer Ta
D Sen�S�nk g��p��q
Lndry Tray Classrtn 5ink
Lab Sink !nt Grea�e Trap Aoaf Dnin
Surgeons Sink _ Exc G�'e;se T�p Standp Rrc
Pluctr Sink grcakrm Sink :
Sceriti:cr
Electrie Contraetor OR QElectric�mstallation Verification �'o�m attachet
urR�i�«��>
Ust/NaEure of Wor�C
Size Matena! Type # �,T'
Sanitacy Sewer � :
Storm Sewer
Water ServiCe
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