HomeMy WebLinkAbout0098480 POSHKOSH
ON THE WATER
Job Address 2590 VILLAGE LN
Contractor MERTEN PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner CRAIG D/PAMELA UBBELOHDE
Category 411 - Residential-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F PrepSink 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 ServSink 0
Lavatory 0 Lndry Tray 0 Local Waste 0 Wait, St. 0 Shamp Sink 0
Toilet 0 LndryStndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 0 BeerTap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 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 98480
Create Date 11/07/2002
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
FFPJ
Install gas water heater.
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
Valuation $1,211.01 Plan Approval $0.00 PermitFees $20.00
Issued By
Date
11/07/2002
[] 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 1087 COZY LANE OSHKOSH WI 54901 - 0000 Telephone Number
231-6795
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
RECEIVED
NOV 0 6
DEPARTMENT OF
COMe, UNITY DEVELOPMENT
O/HKO/H
ON THE WATER
Plumbin Permit Application
I hereby apply for a permit to do and install tl~ following plumbing on the premises hereinafter described, the work to conform,to thc
Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
t /
Job Address o~O I/'/IO~E"LJa' Value0nc,uding,a~o,~ndm~t~al,) /~ll.0t Date
Owner ~d]O LZC Contractor ~/~o/t~.?.~'
[~]Single Family [--ll)uplex [--]Multi-Family ['-Igental ['-]Commerc,~al I-]Industrial
Number of Fixtures:
Bathtub Ladry Standp Dent. Oper. Sharr~ Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Fm Catch Basin
Toilet Sump Pump Wait. St. Wash Fm
Res. Sink .......... Ejector/Grind Ice Chest Urinal
Bar Sink Water Soffner Exam Sink Gar Drain
Water Heater ] ,. Local Waste Scurfy Sink Soda Disp
Shower Clothes Wshr Hand Sink Coffee Maker
Floor Drain Bidet F Prep Sink lee Maker
Lndry Tray Beer Tap Serv Sink Site Drain
Lab Sink Classrm Sink Iht Grease Trap Roof Drain
Plaster Sink Surgeons Sink Ext Grease Trap Standp Ree
Steriliz~ Breakrm Sink
Electric Contractor
Use / Nature of Work
OR
[] EIV form attached (If Replacement)
Size Material Type
Sanitary Sewer
Storm Sewer
# Conn. Type
Water Service
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 greate-(.
OR
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