HomeMy WebLinkAbout0102845-Plumbing (water heater)OSHKOSH
ON THE WATER
,Job Address 1502 N MAIN ST
Contractor KOCH PLUMBING
Bathtub 0 Shower
Whirlpool 0 Floor Drain
Lavatory 0 Lndry Tray
Toilet 0 Lndry Stndp
Res. Sink 0 Disposal
Bar Sink 0 Dishwasher
Water Heater 1 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner MR/MRS RALPH M DIBIASIO-SNYDER
Category 411 - Residential-Water Heaters
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
0 WaterSoftner 0 Drink Ftn 0 ServSink 0
0 Local Waste 0 Wait. St. 0 ShampSink 0
0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
0 Bidet 0 Exam Sink 0 Catch Basin 0
0 Beer Tap 0 SculrySink 0 Wash Ftn 0
0 Dent. Oper. 0 Hand Sink 0 Urinal 0
0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 102845
Create Date 07/15/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$435.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date 07/15/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 2005 DOTY ST OSHKOSH WI 54901 - 0000 Telephone Number
BUTCH (C)379-8753
Phone! (920)
Fax: (920) 236-5084
,OJHKO_/H
Plumbing ,Permit ApPlicatibn
I hcrcby apply fo,' a pcmfit lo do and iaslall tile following plumbing o~ 0~¢ premises hereinafter dcscribcd, file work lo conform lo tl~c
Wisconsin Slam I~tumbm8 Cod¢~ in thc pcrformaacc of which all panics hereto agree lo and are bound by ,~aid smmtc~.
E]lndustrial
Number of Fixtures:
Rcs. Sink
Electric Contractor
Use / Nature of Work,
Sanitary Sewer
S roma Sewer
Water Service
Site D~in
8~dp Rec
OR [3 EIV form attached (IfReplacement)
Size Material Type # Conn. Type
Application(s) and fee(s) can tm brought to City Hall, Room 205 or ma/led to Inspection Services, PO Box 1128, Oshkosh WI
54903-1128. Commencing work without permit(s) will result in fees being doubled o~ $100.00 plus the normal permit fee,
which ever is greater.
OR
Check here if you wane chis ~rocessed through you~ ac¢oun: [~
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