HomeMy WebLinkAbout0099188-Plumbing VOIDOSHKOSH
ON THE WATER
Job Address 505 W IRVING AVE
Contractor E C MERRILL INC
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner JEFFREY L/SUE A WICtNSKY
Category 410 - Residential-Interior
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 WaterSoftner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 LndryTray 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 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 99188
VOID
Create Date 12/26/2002
Plan
Gar Drain 0
Soda Disp 0
Coffee Maker 0
Int Grease Trap 0
Ext Grease Trap 0
Use/Nature
of Work
Duplex / 2nd water meter installationlncorrect address, reissued for 504 W Irving
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 $750.00 · Plan Approval $0.00 Permit Fees $20.00
Issued By
Date 12/26/2002
[] Permit Voided j see #99189
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
OSHKOSH WI 54904 - 0000 Telephone Number
Address 1570 N OAKWOOD 233-2661
OSHKOSH
ON THE WATER
Job Address 505 W IRVING AVE
Contractor ADAMS PLUMBING
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 0 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JEFFREY L/SUE A WICINSKY
Category
410 - Residential-Interior
Ejector/Grind 0 DipWell 0 F Prep Sink 0
Water Softner 0 Drink Ftn 0 Serv Sink 0
Local Waste 0 Wait. St. 0 Shamp Sink 0
CIothesWshr 0 Ice Chest 0 FIrNVst Sink 0
Bidet 0 Exam Sink 0 Catch Basin 0
Beer Tap 0 SculrySink 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 99188
Create Date 12/26/2002
Plan
Gar Drain 0
Soda Disp 0
Coffee Maker 0
Iht Grease Trap 0
Ext Grease Trap 0
Use/Nature
of Work
Duplex /
2nd water meter installation
Valuation $750.00
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
Plan Approval $0.00 Permit Fees $20.00
Date 12126/2002
[] Permit Voided j
In the performance of tbi~work, I agree to perform all work pursuant to rules governing the described construction.
Signature ~' ~,~L,~_I _~-~.~,,,_~__,~._ Date
Agent/Owner
Address 1570 N OAKWOOD OSHKOSH WI 54904 - 0000 Telephone Number
City of Oshkosh
Inspection Services Division
P OBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
ON THF WATER
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 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. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
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~(-~ (,'Q ~3,>.tl0,l~ Value (Including labor and materials) '7~..%~), ~
Owner ~O14, e..~, ~;~ (3 Faa. O,< Contractor //Jng~ /3[f~C~
[-]Single Family [z~Duplex [-]Multi-Family l--]Rental [--]Commercial
Date/
[--]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Fto Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Disp
E Gas Q Elect Q PwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Int Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work
~lElectric Installation Verificati6n form attached
(If Replacement)
Sanitary Sewer
Size
Material
Type # Conn. Type
Storm Sewer
Water Service
3/02