HomeMy WebLinkAbout0102909-Plumbing (bathroom remodel)OSHKOSH
ON THE WATER
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
No 102909
JobAddress 401 STEVENS CT Owner WILLIAM/ANGELA HUMBURG Create Date
Contractor HOMEOWNER Category 410- Residential-Interior Plan
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp
Lavatory 1 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker
Toilet 1 Lndry Stndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int GreaseTrap
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 0 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 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 0
07/17/2003
Use/Nature
of Work
REMODEL BATHROOM
Valuation
Issued By
Storm Water
$1,000.00
Size
Plan Approval
Material
Permit Fees
$0.00
Type
# Conn. Type
$20.00
Date
07/17/2003
Permit Voided
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 401 STEVENS CT OSHKOSH WI 54901 5348 Telephone Number
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
OSHKOSH
ON THE WATER
Job Address 401 STEVENS CT
Contractor HOMEOWNER
Bathtub 0 Shower 0 EjectorlGrind
Whirlpool 0 Floor Drain 0 Water Softner
Lavatory 1 Lndry Tray 0 Local Waste
Toilet I Lndry Stndp 0 Clothes Wshr
Res. Sink 0 Disposal 0 Bidet
Bar Sink 0 Dishwasher 0 Beer Tap
Water Heater 0 Sump Pump 0 Dent. Oper.
Site Drain 0 Classrm Sink 0 Lab Sink
Roof Drain 0 Breakrm Sink 0 Sterilizer
Owner WiLLIAM/ANGELA HUMBURG
Category 410- Residential-Interior
No 102909
Create Date 07/17/2003
Plan
0 Dip Well 0 F Prep Sink 0 Gar Drain 0
0 Drink Ftn 0 ServSink 0 Soda Disp 0
0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
0 Ice Chest 0 FIr/Wst Sink 0 Int GreaseTrap 0
0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
0 Sculry Sink 0 Wash Ftn 0
0 Hand Sink 0 Urinal 0
0 Plaster Sink 0 Standp Rec 0
0 Surgeons Sink 0 Ice Maker 0
Use/Nature
of Work
REMODEL BATHROOM
Valuation
Issued By
Storm Water
Size
Material
Type # Conn. Type
0
$1,000.00 Plan Approval $0.00 Permit Fees $20.00
Date 07/17/2003
[] Permit Voided
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 perfoi'mance of this work¢t~o perform all workgJ~r, sua~t to rules governing the described construction.
Signature [~-~~"~ ~"~-- ("~-~-~'/ Oate--V-l~7 --O'~
Agent/Owfler
Address 401STEVENS CT OSHKOSH WI 54901 5348 Telephone Number ~"~"~--/I/'~L,,~:D