HomeMy WebLinkAbout0103277-Plumbing (tub/shower valve)OSHKOSH
ON THE WATER
,Job Address 855 HERITAGE TRL
Contractor ,JEFF DUPEY
Bathtub 1 Shower
Whirlpool 0 Floor Drain
Lavatow 0 Lndry Tray
Toilet 0 Lndry Stndp
Res. Sink 0 Disposal
Bar Sink 0 Dishwasher
Water Heater 0 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner GORDONV/CORALI RUEDINGER REV TRUST
Category 410- Residential-Interior
No 103277
Create Date 08/04/2003
Plan
0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
0 WaterSoftner 0 Drink Ftn 0 ServSink 0 Soda Disp 0
0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0 Iht Grease Trap 0
0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
0 Beer Tap 0 SculrySink 0 Wash Ftn 0 RPZValve 0
0 Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 0
0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature ~FPJInstall a tub/shower and valve.
of Work
Valuation $700.00
Issued By
Sanitary Sewer
Storm Sewer
WatarSe~ice
Size Material Type #
Corm. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Plan Approval $0.00 Permit Fees $20.00
[] Permit Voided J
Date 08/04/2003
In the performance of this work, I agree to peCc~:m all work pursuant to ru es govem ng the descr bed construction
.:" .-: . D
Signature1.,. '~ %,~,~,~ ~.1 '~ ~ ? ateZT~ (-
t~ Agen~O~
Address 59 W WAU~U AVE Oshkosh (~1 ~902 - 0000 Telephone Number 236-9222
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
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O./HKO/H
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, the ~vork to conform to the
Wisconsin State Plumbing Code, in the performance of which all part/es 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account F~
Job Address_~.~.~/{~'.~i~A~ '~I~P~! Value (lncludinglaborandmatefials)~ 7(")/'), / Date ~-~/
Owner Contractor '~ "~\, ? C~/~"[~,C~
/~Single Family ~Duplex ~Multi-Vamily ~Rental ~Commercial ~Indnstrial
Number of Fixtures:
Bathtub ~/~''1 Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Fm Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Sol,ncr Exam Sink Gar Drain
Water Heater Local Waste Seulry Sink Soda Disp
[3 Gas [2 Elect [] PwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain
Beer Tap Serv Sink Site Drain
Ladry Tray Classrm Sink Iht Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink
Breakrm Sink RiP.Z. Valve Eye Wash Stn
Sterilizer
Electric Contractor
Use / Nature of Work
OR
[~]Electric Installation Verification form attached
(If Replacement)
Sanitary Sewer
Storm Sewer
Water Service
Size
Material Type # Conn. Type
7/03