HomeMy WebLinkAbout0103742 POSHKOSH
ON THE WATER
,Job Address 683 JEFFERSON ST
Contractor M P KELLY
Bathtub 0 Shower 0
Whirlpool 0 Floor Drain 0
Lavatory 0 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 0
Bar Sink 0 Dishwasher 0
Water Heater 1 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner BARRY L HAESE
Category 411 - Residential-Water Heaters
No 103742
Create Date 08/27/2003
Plan
Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Beer Tap 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 0
Lab Sink 0 Plaster Sink 0 Standp Rec 0
Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature DUPLEX/RENTAL/Replace gas water heater.
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 $499.00 Plan Approval $0.00 Permit Fees $20.00 ~ Permit Voided
Issued By
Date
08/27/2003
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.
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.
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5054
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 perforr~nce of which all parties hereto agree to and are bound by said staanes.
· 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 Heater.
OR
If you are a contractor participating tn the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account
Job AddresS ~0 ~(~ ~ Value (inciuains inbo, and rnat~wials}_,.~//~~ ?~ ff 0 .....
Owner ~.~ ' f//~Zg~Z.¢__..- Contractor
[-qSingle Famdy' [-~Duplex [~Multi-Family ~,fital [--~Commercla! [-'~Industrlal
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Sham~ Sink
Whirlpool DJspos~l Dip Well Iqr/W~t Sink
Dishwasher Drink Fm Catch Basin
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Sofmer Exam Sink Cm' D~in
Wa~r~er / Local Waste Sculry Sink Soda Disp
L~b Sink Surgeons Sink Ext Grease Trap St~ Rec
Sterilizer
Electric Contractor
Use / Nature of Work
Sanitary Sewer
Storm Sewer
Water Service
[-']Electric Installation Veriflcati6n form attached
Size Material Type #
Conn. Type
3/02