HomeMy WebLinkAbout0103798-Plumbing (toilet)OSHKOSH
ON THE WATER
.lob.Address 105 E MELVIN AVE
Contractor M P KELLY
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner OKHUIFINK
Category 410 - Residential-Interior
No 103798
Create Date 08/28/2003
Plan
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 0 Lndry Tray 0 LocaIWaste 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 RENTAL/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 $644.00 Plan Approval $0.00 Permit Fees $20.00 ~J Permit Voided
Issued By
Date
08/28/2003
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
POBox I130
Oshkosh, WI 54903-1130
Phone: (920) 236-$050
Fax: (920) 236-5084
RECEiVEi
2 8 2003
DEPARTMENT OF'"-
TY DEVELOPMENT
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 perfor~nce of which ali parties hereto agree to and are bound by said s~atutes.
· 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 in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account [~
Job Address / ~c-~'~'/~x~'/~'` ~1// Value (l.cl.di.s labor and mat~a'sL3
Owner /9~ 7/~ Contractor
. ~'/ -~/' .
~Single Family ~Duplex ~Multi-Family ~ental ~Commercial ~lndustrial
Number of Fixtures:
Bathtub Lndry Standp D~nt. Oper. S~i~'Sifik
Whirlpool ~1 ~p Well ~ Sink
~t~ Dish~sh~ ~nk Fm CaSh ~s~
Toilet / Su~ Pu~ Wait. St. W~h F~
R~. S~k Ej~t~/ONnd Ice Chest
Bat Sink Wa~ So~ Exam Sink
Wat~ H~t~ ~al Waste Scul~ Sink
D ~ E EI~I U ~Vnt Cloth~ Wshr Hand Sink Co~ Mak~
S~ Bid~ .... F Pr~ Sink l~ Mak~
Fl~ ~in B~ Tap Se~ Sink Si~
~d~ Troy Class~ Sink Int G~ase Trap
~b Sink Su~s Sink Ext ~as= Trap
Plum Sink Bma~ Sink
St~li~
Electric Contractor
'Use / Nature of ~ork
S Material
ISanitmy Sewer .
Storm Sewer
Water Service
O'R [-IElectric Installation Veriflcatirn form attached
Type # Conn. Type
3/02