HomeMy WebLinkAbout0098359-Plumbing (tub/shower module)OSHKOSH
ON THE WATER
Job Address 634 GRAND ST
Contractor GLAZE PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner ROSINA C LUCKOW
Category 410 - Residential-Interior
Bathtub 1 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 Water Soffner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 LndryTray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
BarSink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 0 Sump Pump 0 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 0
No 98359
Create Date 11/04/2002
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
0
0
0
0
0
Use/Nature SFR/Replace tub/shower module.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$1,600.00 Plan Approval $0.00 Permit Fees $20.00
Date
11/04/2002
[] Permit VoidedI
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 1865 JAMES RD OSHKOSH WI 54904 - 6873 Telephone Number
589-4014
City of' Oshkosh
Inspection Services D/vision
P O Box 1130
Oshkosh 'N'I 54903-1130
Phone: (92 O) 236-5050
Fax: (920) 236-5084
ON THE
Applicat' x
PlumbIng
Permit
I hereby apply for a pe~t ,o do and instal[ the following plumb~g on the pre~ses her~t~~ ~ ~,~.u ~
'~sco~m. [ umomg cone, m me pedBmnce of winch alt pomes h~h~6 ~fid are. bo~d by said statues.
Application(s) and fee(s) can be brought to City Hall, RoOm 205 or mailed to InsPection Services, PO Box 1 I28,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal perrmt fee, whichever is greater.
OR
lf vou.~ ........ are a co,ntrac r~rrici~ating, .. . _ in the Permit Fee Account System. and have adequate funds, check here
(f.vou wqnt Lhis~rocessed throu_gh your account ~-~ --
OWner ~[J(czt41 /-,t~cKeu/ Contractor b~/'~_ ~'t~& ~'~'aG
[~Si~gle Family [-]Duplex [-']Multi-Family [~Rental [~CommerciaI
Date~
[-]Industrial
Number of Fixtures:
Bathtub _ [ Lndry Standp Dent. Oper. Sharrrp Sink
Whirlpool Disposal Dip We!l Flr/Wst Sink
Lavatory Dishwasher Drink Ftn Catch Basin
Toile~ Sump Pump Wait, Si, Wash Ftn
Res. Sink Ej¢¢tor/Gr/nd ~ce Chest ~ Urinal
Bar Sink Water Soflner
~ Exam Sink Gar Drain
Water Heater ...... Local Waste __ Sculrs' Sink
- O~s Y, Elect _~ PwrV~t ...... Soda Disp
Clothes Wshr Hand Sink Coffee Maker
Shower
Bidet F Pr~ Sink Ice Maker
Floor Drain
Be~ Tap S~rv Sink ~ Site Dmi'n
Lndry Ir'ay Ciassrm Sink Int Grease Trap Roof Drain ·
Lab Sink
Surgeons Sink Ext Grease Trap Standp Rec
Piaster Sink
Breakrm Sink
Sterilizer
Electric Contractor
lSanitary Sewer
Storm Sewer
Water Service
~Electric Installation Verification form attached
(If Reptacemeht)
Size Material Type # Conn. Type
3/02