HomeMy WebLinkAbout0107184 P SHKOSH
ON THE WATER
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
JobAddress 208W LINWOOD AVE Owner DAVID F/LAKIETH POULSEN
Contractor HOMEOWNER Category 410- Residential-Interior
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn
Lavatory 1 Lndry Tray 0 LocaIWaste 0 Wait. St.
Toilet 0 Lndry Stndp 0 CIothesWshr 0 Ice Chest
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink
Bar Sink 0 Dishwasher 0 Beer Tap 0 Sculry Sink
Water Heater 0 Sump Pump 0 Dent. Oper. 0 Hand Sink
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink
0 F Prep Sink
0 Serv Sink
0 ShampSink
0 FIr/Wst Sink
0 Catch Basin
0 Wash Ftn
0 Urinal
0 Standp Rec
0 Ice Maker
No 107184
Create Date 04/01/2004
Plan
0 Gar Drain
0 Soda Disp
0 Coffee Maker
0 Int GreaseTrap
0 Ext Grease Trap
0 RPZ Valve
0 EyeWash Statn
0
0
Use/Nature
of Work
REPLACE LAVATORY
Valuation
Issued By
Storm Water
Size Material
Type #
Conn. Type
0
0
0
0
0
$150.00 Plan Approval
$0.00 Permit Fees
$20.00 L~ Permit Voided
Parcel Id #
1516680000
Date 04/01/2004
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.
Signature Date
Agent/Owner
Address 208W LINWOOD AVE OSHKOSH WI 54901 1964 Telephone Number 651-9465
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.
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.