HomeMy WebLinkAbout0099476 POSHKOSH
ON THE WATER
JobAddres$ 1018WNEWYORKAVE
Contractor GLAZE PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner FRANCIS M KOERWITZ
Category 410 - Residential-Interior
Bathtub 1 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 1 Lndry Stndp 0 ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 1 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 1 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 99476
Create Date 01/16/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace WC, BT, KS & DW.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$3,850.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$24.00
Date
01/16/2003
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 1865 JAMES RD OSHKOSH WI 54904 - 6873 Telephone Number
589-4014
C~ty of Oshko~h
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
I hereby apply for a permit to do and in~tall the fo/lowing plumbing on the premises here~ described, the work to ¢o~'otm to the
Wisconsin Slate Plumbing Code, in the performance of which all parties hereto agree to and are. bound by said statutes.
Application(s) ad fee(s) can be brought to City Hall, Room 205 or mailed to Inspeotioa Services, PO Box 1128,
Oshkosh WI 54903-t128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal p~-~nit f~c, whioh ever i~ greater.
OR
If_you ar~2a .c~'ntractoJ' pa~ticZ~atine in the_ PermitFee~Account_$v&rerr~and ha~e ad~quate2fi~nds, ch~ck~ere
[~gle Family [~]Dnplex [~]Multl-Family r-IRental ["]Commercial
["]industrial
Number of Fixtures:
Whirlpool
Toilet
Res. Sink
gar Sink
tn(~.~ StanO Dent. Oper. S)um~ S~.k
Disposal ,,. Dip W~[! ..... FIr/Wsi Sink
Su~ ~ WMI, St. ~ Wash ~
Ej~l~/Odnd 1~ Ch~t ~ U~I
CIoLh~ Ws~ Ha~ Sink Coff~ M~
Bid~ F Pr~ Sink Ice Mak~
~ T~ Sc~ Sink Site ~m
Cla~ S~k ..... l~t ~e Trap ._. R~f ~
Sutg~ Sink ~t O~ Trap Smn~
~ Sink
/Nature of Work ~-~ t~)C,
[--IElectric Instalhition Verifleati6n form attached
(lf Replacement)
T~ ~ ~ T~e
Sanita~ Sewer
Size Material
Water Service
3/0~