HomeMy WebLinkAbout0103434-Plumbing (toilet)OSHKOSH
ON THE WATER
,Job Address 840 EVANS ST
Contractor M P KELLY
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner GEORGE A BLITZ
Category 410 - Residential-Interior
No 103434
Create Date 08/11/2003
Plan
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Soffner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 0 Lndry Tray 0 LocalWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 1 Lndry Stndp 0 ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0 RPZValve 0
Water Heater 0 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash 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 0
Use/Nature SFR/ Replace toilet.
of Work
Size Material Type # Conn. Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Valuation $289.00 Plan Approval $0.00 Permit Fees $20.00 ~J Permit Voided
Issued By
Date 08/11/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 665 N MAIN ST OSHKOSH WI 54901 - 4431 Telephone Number
231-1750
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.
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
,~-., ...t ./~"r'-~ ~-..
Fax:
(920)
236-5084
AU0 I12003
· D£PAR, I'MENT Of
Plumbing Porrnlt i i ii £LOPMENT
I hereby apply for a pe~t to do and install the followi~g plumbing on the pre~ses hereina~er descdbed, ~e work to confom to the
Wisco~in State Plumbing Code, in the perfomnce of which all panics hereto agree to and are bo~d by said s~tes.
Application(s) and fee(s) c~ be brought to Ci~ Hall, Room 205 or mailed to Bspection S~ces, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pemit(s) will result in fees being doubled or $100.00 plus the
nomal pemit fee, which ever is ~eater.
l[Fou are a contractor parHc~pating in the Permit Fee ~ccount SFstem and have adequate [unds. check her,.
~[Fou want this processed through your account ~
owne~ ~~(~~ Contractor ~~/~/ /~,
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper, Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory ~ Dishwasher Drink Ftn Catch Basin
Toilet ~ Sump Pump Wait. St. Wash Fm
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Sol~ner Exam Sink G~t Drain
Water Heater Local Waste Sculry Sink Soda Disp
Clothes Wshr Hand Sink Coffee Maker
Shower
· . Bidet ~ F Prep Sink Ice Maker
Floor Drain
Beer Tap Serv Sink Siie Drain
Lndry Tray Classrm Sink lnt Grease Trap Roof Drain
Lab Sink
Surgeons Sink Ext Grease Trap S~ Rec
Plaster Sink
Breaknn Sink
Sterilizer
Electric Contractor
'Use/NatureofWork ,~~A~ ,~)~nt)
/
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
O-R [-'lElec. tric Installation VerificatiOn form attached
3/02