HomeMy WebLinkAbout0099436-Plumbing (sewer lateral)OSHKOSH
ON THE WATER
JobAddres$ 1215 W BENT AVE
Contractor M P KELLY
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner ERIC J/ANNMARIE JOHNSON
Category 401 - Residential-Exterior (laterals)
Bathtub 0 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 Lndry Tray 0 LocalWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 Lndry Stndp 0 ClothesWshr 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 99436
Create Date 01/13/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
RELAY SAN SEW LATERAL
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
4 Plastic Lateral
$1,800.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
1 Relay
0
0
0
0
0
0
0
0
0
0
0
0
$25.00
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 665 N MAIN ST OSHKOSH WI 54901 - 4431 Telephone Number
231-1750
City of' Oshkosh
I~on Services Division
POBox 1130·
f,..~ Oshkosh, WI ~90~-1130
phone: (9R0) 236-~0~0
Fax: (920) 236-5084
Plu mbing
RECEIVED
JAN 1 5 2005
DEPARTMENT OF
::0' · T
'1
QfI-KOYH
ON 7141:
I hereby apply for a permit to do and install the following plumbing on the prermses 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 raid 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 _re'eater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate _funds,.¢heck here
if_~ou want this processed thr. o.ugh Four .account ~
Owner ~._.~ ~'~'"'~ Contractor
~}S~ngle Family [~Dnplex r'lMulti-Family
LJRentai I ICommerelal r-Ilndustrlal
Number of Fixtures:
Bathtub , Lndry Standp Dent. Ope~.
Whirlpool Dislx~a! Dip Well
Dishwasher Drink Fm
Toilet ,, Sump Pump Wait. St.
Res. Sink Ejector/C~Jnd lee Chest
Bw Sink Water Soflner Exam Sink
Water Heater Local Waste Sculry Sink
r~ Oas U Elect D Pwrvnt Clothes Wahr Hand Sink
Shower Bhiet F' Prep Sink
Floor Drain Be~r Tap Serv Sink
t. ndry Troy Classrm Sink In! Grease Trap
Lab Sink Surgeons Sink Ext Grease Trap
Plt~ter Sink Breaknn Sink
Sterilizer
Electric Contractor.~-----. O'R [--]Electric Installation VerifiCatiOn form attached
o~~
Use / Nature of W
Sanitary
Storm Sewer
Water Service
Size Material Type # Conn. Type
3/02