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CITY OF OSHKOSH
109737
No
OSHKOSHPLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address3265 S WASHBURN STOwnerBERGSTROM FOX VALLEY INCCreate Date08/03/2004
ContractorOGDEN PLUMBINGCategoryPlan
440 - Industrial-Interior
Bathtub0Shower0Ejector/Grind0Dip Well0F Prep Sink0Gar Drain0
Whirlpool0Floor Drain3Water Softner0Drink Ftn0Serv Sink00
Soda Disp
Lavatory12Local Waste0Wait. St.0Shamp Sink00
Lndry TrayCoffee Maker
Toilet10Clothes Wshr0Ice Chest0Flr/Wst Sink0
0
Lndry Stndp
Int Grease Trap
Res. Sink00Bidet0Exam Sink0Catch Basin1
Disposal0
Ext Grease Trap
Bar Sink000Wash Ftn1
Beer Tap0Sculry Sink
Dishwasher
RPZ Valve0
Water Heater200Urinal0
Sump PumpDent. Oper.0Hand Sink
1
Eye Wash Statn
Site Drain000Standp Rec0
Classrm SinkLab Sink0Plaster Sink
Roof Drain200Ice Maker0
Breakrm SinkSterilizer0Surgeons Sink
Use/Nature Addition & remodel service garage
of Work
SizeMaterialType#Conn. Type
Sanitary Sewer0
0
0
0
0
Storm Sewer0
0
0
0
0
Water Service0
0
0
0
Parcel Id #
0
1365010000
$0.00Permit Voided
Valuation$20,000.00Plan ApprovalPermit Fees$98.00
Issued ByDate08/03/2004
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
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.
Date
Signature
Agent/Owner
AddressPO BOX 689NEENAHWI54957-0689Telephone Number836-3220
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.