HomeMy WebLinkAbout0099422 POSHKOSH
ON THE WATER
,Job Address 1255 PHEASANT CREEK DR
Contractor HANSON QUALITY PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner RUSCH HOMES
Category 410 - Residential-Interior
Bathtub 1 Shower 2 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 1 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 3 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 3 Lndry Stndp 1 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 1 Disposal 1 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 1 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 Sump Pump 1 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 1
No 99422
Create Date 12/16/2002
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$5,700.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$102.00
Date
01/13/2003
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 550 N BLUEMOUND RD APPLETON WI 54914 - 0000 Telephone Number
730-0205
City of Oshkosh
Inspection Services Division
POBox 1130 dA, h,,t
Oshkosh, WI 54903-1130
Phone: (920) 236-5050 r,f¥~ - r'-'x ......
Fax: (920) 236-5084
I hereby apply for a pe~t to do ~d ~mll the fOllowing plmbmg on ~e premses hereinafter des~bed, ~e work to coffom-- to ~e
Wiscomin State Plumbing Code, ~ ~e peffomnce of which all paffies hereto a~ee to and are bo~d 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. Commencing work without permit(s) will result m fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
,rf vou are a contractor participating in the Permit Fee Account System and have adequate fundx, check here
if you want this processed throuch vo~r account [~
Job Address /~z~ ~//~cz~z.,~/f_J.4, Vahle (Including labor and materials) ~--.-~'}- ~'~ Date
Owner r¢,
~Single Famiiy U]I)uplex [--]Multi-Family [-"]Rental ['-]Commercial ['-]Industrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
/
~Gas - Elect _- PwrVnt
Shower 3
Floor Drain /
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Lndry Standp / Dent. Open Shamp Sink
Disposal } Dip Well Flr/Wst Sink
Dishwasher ] Drink Fm Catch Basin
Sump Pump [ Wait. St. Wash Fm
Ejector/Grind Ice Chest Urinal
Water Sofmer Exam Sink Gar Drain
Local Waste Scutry Sink Soda Disp
Clothes Wshr Hand Sink Coffee Maker
Bidet F Prep Sink lce Maker
Beer Tap Serv Sink Site Drain
Classrm Sink Int Grease T'mp Roof Dram
Surgeons Sink Ext Grease Trap Standp Rec
Bre~krm Sink
Electric Contractor
Use / Nature of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
['-]El(~e~c~erpi~eI~n~,stt)allation VerificatiOn form atta~e/d
3/02