HomeMy WebLinkAbout0103286-Plumbing (interior)OSHKOSH
ON THE WATER
.lob Address 1130 N WESTFIELD ST
Contractor BASSETT MECHANICAL
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner EVERGREEN MANOR INC
Category 410 - Residential-Interior
Bathtub 0 Shower 10 Ejector/Grind 0 DipWell 0 F Prep Sink
Whirlpool 2 Floor Drain 49 Water Soffner 1 Drink Ftn 1 Serv Sink
Lavatory 50 Lndry Tray 0 LocalWaste 0 Wait. St. 0 Shamp Sink
Toilet 50 Lndry Stndp 4 ClothesWshr 0 Ice Chest 0 FIr/Wst Sink
Res. Sink 19 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin
Bar Sink 0 Dishwasher 3 Beer Tap 0 SculrySink 0 Wash Ftn
Water Heater 1 Sump Pump 1 Dent. Oper. 0 Hand Sink 0 Urinal
Site Drain 3 Classrm Sink 0 Lab Sink 6 Plaster Sink 0 Standp Rec
Roof Drain 2 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker
No 103286
Create Date 08/01/2003
Plan
0 Gar Drain
4 Soda Disp
2 Coffee Maker
2 Int Grease Trap
0 Ext Grease Trap
0 RPZ Valve
0 EyeWash Statn
0
0
0
0
0
0
0
0
0
Use/Nature Nursing Home/Addition.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$263,358.00 Plan Approval $0.00 Permit Fees $1,260.00
Date 08/05/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1215 HYLAND AVE PO BOX 7000 KAUKAUNA WI 54130 - 0000 Telephone Number
800-236-2502==920-;
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.
0i~7 of Oshkosh
· ,,Spection Servlc~s Division
??) Box ! 130
O~hkosh, WI 54903-1130
Phone: (920) 236-5050
7~x: (920) 236-5084
~ Oshkosh '~nsPe~%ions
~20-~3~-5084
O/HKO/H_'
Plumbing Permit Application
Wisconsin Stmte Plumbing Code, m the perfommnce of which ali pames hereto agree to and arc oamncl oy sam s~amtes
~ Application(s) and fee(s) c~n be brought to Ciw Halt, Room ~05 or mailed to ~ection Sea, ices, PO Box 112g,
Oshkosh WI 54903-1128. Commencing work without pe~it(s) ~11 result in fees being doubled or $100.00 plus the
no~a~ pc~it fee, which ever is ~ater.
O~ . . Sy$~e~and h~v~a~e~uate funds, ch~ck here
~iou ar~ a (ontractor. parZ~cipattn~n the Permit Fee Account
._ . t~rou~'h your accou~2t ~
~anl this processed
Value (Incldd:ng ~abor and mm~cnals)~Z~ ~r ~ ~ Date V ' ~; - O~
Job Address~l~W~a~o ~r. .
Contractor ~SC~ ~CC~A~tO~
~Single Famib' ~Duplex ~Multi-Family ~Rental ~Commercial ~~ndustri'l
iumber of Fixtures:
Lnd~y Slandp ~ Dcm. O~c~. FIr/Ws~ Sink ~ .
~v~o~ ~0 Dishwasher --~ Drink Fm --~ Wash Fm --
Toilet ~0 Sump Pu~
Walcr Sofmcr ~ / Exam Sink
Sink ~ Surgeons Sink ~~~ Ext Grease Trap
Sterilizer ~ ~
~Eleetric Installation Verifieatidn form attached
Electric Contractor ~ (lrRcplae~nt)
Use/Nature
Size
Sanitary Sewer
Material Type
# Conn. Type