HomeMy WebLinkAbout0106418-Plumbing (remodel bathroom)
CITY OF OSHKOSH
106418
No
OSHKOSHPLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address821 N SAWYER STOwnerDAVID M/ROXANNE LEMIEUXCreate Date02/10/2004
ContractorKOCH PLUMBINGCategoryPlan
410 - Residential-Interior
Bathtub1Shower1Ejector/Grind0Dip Well0F Prep Sink0Gar Drain0
Whirlpool0Floor Drain0Water Softner0Drink Ftn0Serv Sink00
Soda Disp
Lavatory10Local Waste0Wait. St.0Shamp Sink00
Lndry TrayCoffee Maker
Toilet10Clothes Wshr0Ice Chest0Flr/Wst Sink0
0
Lndry Stndp
Int Grease Trap
Res. Sink10Bidet0Exam Sink0Catch Basin0
Disposal0
Ext Grease Trap
Bar Sink000Wash Ftn0
Beer Tap0Sculry Sink
Dishwasher
RPZ Valve0
Water Heater000Urinal0
Sump PumpDent. Oper.0Hand Sink
0
Eye Wash Statn
Site Drain000Standp Rec0
Classrm SinkLab Sink0Plaster Sink
Roof Drain000Ice Maker0
Breakrm SinkSterilizer0Surgeons Sink
Use/Nature SFR/Bath remodel
of Work
SizeMaterialType#Conn. Type
Sanitary Sewer0
0
0
0
0
Storm Sewer0
0
0
0
0
Water Service0
0
0
0
Parcel Id #
0
1603490000
$0.00Permit Voided
Valuation$3,000.00Plan ApprovalPermit Fees$35.00
Issued ByDate02/10/2004
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.
Date
Signature
Agent/Owner
Address2005 DOTY STOSHKOSHWI54902-0000Telephone Number920-231-6661 or 235-0282
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.
City of Oshkosh
= s Inspection Services Division
P O Box 1130
Oshkosh, WI 54903 -1130 , ,'.
Phone: (920) 236 -5050
Fax: (920) 236 -5084
A
Plumbing Permit Application
•
I hereby apply for a permit to do and install the following plurnbing on the premises hereinafter described, the work to conform to the
• Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
• • Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903 -1128. Commencing work without permit(s) will result in fees being doubled or 5100.00 plus the
normal permit fee, which ever is greater.
OR
if you are a contractor participating in the Permit Fee Account System and have adeauate funds_ check here,
if you want this Processed through your account 14
Job Address 9 l l 0 Value (Including Isbor and materiels) 3 ' ' e " Date F 7 ,
• Owner ,l 1, 0 461164524K Contractor 464 Mme. .
Single Family ❑Duplex DMulti- Family []Rental ['Commercial ['Industrial
Number of Fixtures: � :
• ;
. Bathtub 1 Lndry Standp Dent. Oper. Shame Sink -
Whirlpool Disposal Dip Well Elr /Wst Sink
. ' Lavatory ___L_ Dishwasher Drink Fin Catch Basin
Toilet / Sump Pump Wait. St. Wasb Fin
Res. Sink . / Ejector /Grind Ice Chest Urinal
Bar Sink Water Sultrier Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Dlsp
0 Gas 0 Elect 0 PwrVnt Clothes Wshr Hand Sink Coffee Maw
Slower / Bidet F Prep Sink • Ice Maker
•
Floor p Beer Tap Sery Sink Site Grain
lanky Tray Clsaarm Sink _. — _ Int Grease 1 rap Roof train
Lab Sink Surgeons Sink Est Grease Trap Standp Ric
Plater Sink Break to Sink
Sterilizer
Electric Contractor Q R ❑Electric Installation Verification form attached
�aa (If Replacement)
Use / Nature of Work 2 ,,e-,704.20,02:::.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service __„_
3/02
TO 39 9NI 9NI8kf1"ld H003i Z8Z0 6E:90 000Z/60/Z0