HomeMy WebLinkAbout0102948-Plumbing (interior)OSHKOSH
ON THE WATER
.lob Address 3219 BELLF[ELD DR
Contractor HANSON QUALITY PLUMBING
CITY OF OSHKOSH
No 102948
PLUMBING PERMIT - APPLICATION AND RECORD
Owner CREATIVE CUSTOM HOMES & DEVELOP INC Create Date 07/21/2003
Category 410- Residential-interior
Plan
Bathtub 1 Shower 1 Ejector/Grind 0 Dip Well 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 3 LndryTray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 3 LndryStndp 1 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0 Iht GreaseTrap 0
Res. Sink I Disposal 1 Bidet 0 Exam Sink 0 Catch Basin 0 Ext GreaseTrap 0
Bar Sink 0 Dishwasher 1 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater I Sump Pump I 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
Use/Nature
of Work
Valuation $7,000.00 Plan Approval $0.00 Permit Fees $90.00
Issued By
Date 07/21/2003
[] Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
Signature Date
Agent/Owner
Address 550 N BLUEMOUND RD APPLETON WI 54914 - 0000 Telephone Number 730-0205
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 work to conform to the
Wisconsin State Plumbing Code, in the performance of which all parties hereto a~ee to and are.bound by said ~tatutes.
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 participatin~ in the Permit Fee Account System and have ad'equate funds· check here
if you want this processed throuffh your account ['~
Owner C C~t Contractor ~%~S
~Single Family ["'tDuplex F"]Multi-Family [--]Rental
Date
[~]Industriai
Number of Fixtures:
[ I
Bathtub
Whirlpool Disposal ( Dip V~/ctl
Lavatory .e~ Dishwasher ] Drink Fm
Toilet ,ff Sump Pump [ Wait. Sc
Res. Sink / Ejector/Grind Ice Chest
Bar Sink Water Sofmer Exam Sink
Water Heater / Eocal Waste
~Gas 2 EIem _.Z PwrVni Sculry Sink
Clothes Wshr Hand Sink
Shower / Bidet F Prep Sink
Floor Drain
Beer Tap Sen' Sink
Lndry Tray Classrm Sink Iht Grease Trap
Lab Sink
Surgeons Sink Ext Grease Trap
Pla~ier Sink Breakrm Si~k
Sterilizer
Shamp Sink
Flr/Wst Sink
Ca~eh Basin
Wash Fm
Urinal
Gar Drain
Soda Disp
Coffee Mak~
Ice Maker
Site Drain.
Roof Drain
Smndp Rec
Electric Contractor
Use / Nature of Work
['~Electric Installation Verificati6n for_Lm&ttached
(If Replacement) d?ff.) .~X)
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
3/02
Plumbing Permit Work Card
Jots Address 3219 BELLFIELD DR Permit Number 102948 Create Date 07/21/2003
Owner CREATIVE CUSTOM HOMES & DEVELOP Contractor HANSON QUALITY PLUMBING
"ategory 410 - Residential- Interior Plan Value $7,000.00
thtub 1 Shower , 1 Ejector /Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain / 0 Water Softner 0 Drink Ftn 0 Sery Sink 0 Soda Disp _ _ 0
Lavatory / If 3 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker _ 0
Toilet rir3 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
Water Heater ! 1 Sump Pump 1 1 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 1
Use /Nature
NSFR
of Work
Size Material Type # Conn.Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
1\ 0
0
0
0
Date Type { Inspector
1 ,2 .,2 ,,, y ‘,... 1 . - p (4
Date/Time requested: : Notice Type: Telephone Number:
Access:
Ready Date /Time: Requested By:
0 Reinspect Fee ❑ Fee Waived ❑ Reinspect Fee Paid