HomeMy WebLinkAbout0103001-Plumbing
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OSHKOSH
ON THE WATER
Job Address 3155 HAYWARD AVE
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
No 103001
Owner THOMAS N RUSCH
Contractor HANSON QUALITY PLUMBING
Category 410 - Residential-Interior
Create Date
07/22/2003
Plan
Bathtub 2 Shower 1 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
- - - - - -
Whirlpool 0 Floor Drain 1 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 3 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
- - - - - -
Toilet 3 Lndry Stndp 1 Clothes Wshr 0 Ice Chest 0 Flr/Wst Sink 0 Int Grease Trap 0
-
Res. Sink 1 Disposal 1 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
- - - - - -
Bar Sink 0 Dishwasher 1 Beer Tap 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
- -
Water Heater 1 Sump Pump 1 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 Sterilizer 0 Surgeons Sink 0 Ice Maker 1
Use/Nature NSFR/ gas water heater
of Work
Size
Type
Material
Sanitary Sewer
Storm Sewer
Water Service
# Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$102.00
Valuation
$8,800.00
$0.00
Permit Fees
Plan Approval
Issued By
Date 07/22/2003
U Permit Voided I
Signature
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Date
Address
Agent/Owner
APPLETON
730-0205
550 N BLUEMOUND RD
WI 54914 - 0000 Telephone Number
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
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
~
.OfHKOfH
ON TH' W^TER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, in the performance of which all panies hereto agree to and are. bound by said statUtes.
. Application(s) and feces) can be brought to CitY Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pennit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
œ . . .
If YOU are a contractor varticivatinf! in the Permit Fee Account Svstem and have adeauate funds.. check here
if YOU want this vrocessed throuf!h your account n .
Job Address 3i~ l-\", {~",-"O , Value (Including laborand materials)
I
Owner \:-Kc....+ \"",-t\ ~~ Contractor
. ~Single Family DDuplex DMulti-Family
Number of Fixtures:
BathtUb -2-
Whirlpool
Lavatory
Toilet
~J
~
-L
Res. Sink
Bar Sink
Water Heater -L
"* Gas ::' Elect::' PwrVni
Shower .:'It::.f
Floor Drain --1-
Lndry Tray
. Lab Sink
Plaster Sink
Sterilizer
Electric Contractor
Use / Nature of Work
Sanitary Sewer
Storm Sewer
Water Service
Industrial
Lndry Stmdp
Disposal
Dishwasher
Sump Pump
Ejector/Grind
L
---L
-L-
-L-
Wash Fro
Urinal
Dent Oper.
Dip Well
Drink Fro
Shamp Sink
FlrlWst Sink
Catch Basin
Wait.Sl
Ice Chest
Water Sofroer
Local Waste
Exam Sink
Sculry Sink
Hand Sink
Gar Drain
Soda Disp
Coffee Maker
Clothes Wshr
Bidet
lee Maker
Site Drain
-L-
F Prep Sink
Serv Sink
In! Grease Trnp
Beer Tap
Classnn Sink
Surgeons Sink
Breaknn Sink
Roof Drain
Standp Rec
Ext Grease Trnp
OR
DElectric Installation Verificatiõ
(If Replacement)
Size
Material
Type
#
Conn. Type
3/02