HomeMy WebLinkAbout0099118 POSHKOSH
ON THE WATER
,Job Address 252 N MEADOW ST
Contractor 6LAZE 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 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 ROBERT E/MARY L ROCKOW
Category 411 - Residential-Water Heaters
Ejector/Grind 0 DipWell 0 F Prep Sink 0
WaterSoftner 0 Drink Ftn 0 Serv Sink 0
LocaIWaste 0 Wait. St. 0 ShampSink 0
Clothes Wshr 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 99118
Create Date 12/17/2002
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap __
0
0
0
0
Use/Nature SFPJ Replace 40 gallon gas water heater.
of Work
Size Material Type # Conn. Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Valuation $485.00 Plan Approval $0.00 Permit Fees $20.00
Issued By
[] Permit Voided J
Date
t2/17/2002
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 1865 JAMES RD OSHKOSH WI 54904 - 6873 Telephone Number
589-4014
City of Oshkosh ...~~
Inspection Services ,
POBox 1130
eho,.,e: (92o) 23~soso DEC 'l ~/_u,,¢ ," ,:, ,__ /
D~PARTMENT O~
{;O~'~MUN~TY ~~Tpermit Application
THE WATER
I he.by apply for a permit to do and inatall the following plumbing on the premises hereinafter descn'bed,/he wo~ m ¢oifform to ~e
Wisconsin S~ate Plumbing Code, in the performance of which all parties hereto agree to and are. bound by said siatules.
Application(s) and fee(s) can be brought io City Hall, Room 205 or mailed to hspccfion Serdces, PO Box 1125,
Oshkosh WI 54903-112//. Commencing work without permit(s) will result in fees being doubled or $100.00 plus
nm-mai permit fcc, which cvcr ia greater,
OR
t~ you_are_a .¢~ntractor ~.~rtici~ati~'~ in the_Permit Fee~4ccounLSys__ternx*nd..have adequate~nds~ c!~ckd~ere.
i,£,y~u,wan, t t,h,i~ proee~d,,thr,Ough your at.aunt ["1
Job Address_~ffh. _ k~_/,,,/e~ .. Value (~du~m~ =t~a~) _ ti :7
o,,er 'ak ~- ~f ~.~.~ . co,tra,to~ [-~-G~-~ ~"~
~Single Family [-']Duplex [~]Multt-Family [~]Rental [~]Commercial
E]Industrlal
Number of Fixtures:
~iflp~! ....... Di~o~l Dip Well
~va~ ~sh~ ~ ~n~ im
Toi]~ Su~ Pu~ Wait, St.
~. Sink Eisa/Grind ~e Cfl~t
~= Sihk Wa~ S~ ~ E~m
W~t~ L~ W~ ~ Scul~
/
Sink
G El~t ~t Clo~ Wshr Hand Sink
s~ Bid~ F Pr~
F~r ~in ~ ~ Tap S~ Sink
~ Troy ....... Claim Shk ~t O~e Trap
~b ~ink ~ Surg~ns Si~k ~t Gre~ Trap
PI~ Si~ ~ Br~ Sink
Electric Contractor
Use / Nature of Work
Sanitary Sewer
Storm S~wcr
Wa~r Service
Size
Material
Wash Fm
Coffee Ma~
Icc Mak~
~Electric Installation Veriflc'ati$n form attached
(lt' g~pl~em~nt)
~ T~e
3/02