HomeMy WebLinkAbout0099318-Plumbing (water heater)OSHKOSH
ON THE WATER
,Job Address 1728 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 ALLAN H SCHULTZ
Category 411 - Residential-Water Heaters
Ejector/Grind 0 DipWell 0 F Prep Sink 0
Water Softner 0 Drink Ftn 0 Serv Sink 0
LocaIWaste 0 Wait. St. 0 Shamp Sink 0
CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Bidet 0 Exam Sink 0 Catch Basin 0
Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Dent. Oper. 0 Hand Sink 0 Urinal 0
Lab Sink 0 Plaster Sink 0 Standp Rec 0
Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 99318
Create Date 01/06/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace gas WH under warranty.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size
$148.00 Plan Approval $0.00 Permit Fees
Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date
01/06/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 665 N MAIN ST OSHKOSH WI 54901 - 4431 Telephone Number
231-1750
Ci~ of'Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236.5050
Fax: (920) 236.5084
OJl-KOJ'H
ON ?1-11: W^TER
Plumbing Permit Application
I hereby apply for a permit to do and install the followi .ag plumbing on the prermses hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
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. Comm. encing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
!f ¥ou are a contractor participating in the Permit Fee ~qccount System and have adequa.te funds,, check here
(f you want this processed through your account ~
Job Address /,7~0/~ '-J/~ Value (,ncludin, labor and m~/erial,,... ~VZ~ ~
~]~ingle Family r~Duplex [--lMulti-ramily ['-]Rental [--ICommercial ["'ilndustrlai
Number of Fixtures:
Bnthtub Lndry Stnndp
Whirlpool Disposal
Lavatory Dishwasher
Toilet Sump Pump
Res. Sink Ejector/C-rind
Bar Sink Wate~ Softer
W~este. I Local Waste
D EleCt D PwrYnt Clothes Wshr
Shower Bidet
Floor Drain Beer Tap
Lndry Tray Classrm Sink
14b Sink Surgeo.s Sink
Plaster Sink Breskrm Sink
Sterilizer
Dip Well Jl~ 6 200, ~, f2s t~h l~,in
Drink Fm .
Scul~ Sink ~ ~
Hand Sink Cofl~'e Make'
F Prep Sink --. kt Mike'
Sew Sink Site D~in
Int Grease Trap Reef Orei~
ExI Grease Trap Stsmlp Rec
Electric Contractor
(If Replacement)
Sanitary Se~. S~e Material T~e ~ Co~. i/
/
Sto~ Sew~
Wat~ Se~ice
O'R ['-lElectric Installation VerifleatiSn form attached
3/02