HomeMy WebLinkAbout0099591 POSHKOSH
ON THE WATER
.lob Address 1822 MENOMINEE DR
Contractor M P KELLY
Bathtub 0 Shower 0
Whirlpool 0 Floor Drain 0
Lavatory 0 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 1
Bar Sink 0 Dishwasher 0
Water Heater 0 Sump Pump 1
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner TERI SHORS
Category 410 - Residential-Interior
Ejector/Grind 0 DipWell 0 F Prep Sink 0
Water Softner 0 Drink Ftn 0 Serv Sink 0
LocaIWaste 0 Wait. St. 0 Shamp Sink 0
CIothesWshr 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 99591
Create Date 01/27/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace disposal and sump pump.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$1,969.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date
01/27/2003
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
Cia7 of Oshkosh
I~-ctlon Servlc~ Division
P O Box 1130.
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
Q./FKQfH
Olq Tl~: W^TFa
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumb:ag on the prermses 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. Corr~. encing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit tee, which ever is greater.
OR
l_[ you are a contractor participating in the Permit Fee Account S),stem and have adequate [unds, t;heck here
if you want this, processed through your account ~
Owne~ 7~/~ ~F-~' Co,tractor ~,~~/~, /~ · '
~ngle Family ['-IDnplex ~-']Multi-Famdy i-]Rental I-']Commercial ~Indu,tHal
Number of Fixtures: .........................
Bath~b
w~h~ol
Lavatory
T~let
Res, Sink
B~r Sink
Water Heater
D Gas O Elect r'3 PwrVnt
Shms~r
Floor Drain
l.ndry Tray
Lab Sink
Phmer Sink
Sterilizer
l. mlry St~ndp Dem. Ope..
D~sp~al ,1 Dip Well
Dishwasher Drink' Fm
Su~ Pu~ /, Wail St.
Ej~t~/~nd Icc Ch~t
Wa~ ~ Exam Sink
~1 Waste Scul~ Sink
CI~ Wshr Hand Sink
Bid~ F Pr~ Sink
g~ Tap S~ Sink
~ Sink Ina O~a~ Trap
S~s Sink Exl ~se Trap
B~ Sink
~ Sink
Plt~st Sink
W#h Fm
Ut~l
C~ Make
~ Mak~
R~H
Electric Contractor
Use I Nature'ofWork ~~.~?~ ~
Material
Sanitary Sewer
Storm Sew'er
Water Service
O'R I'-[Eiectric Installation Verlflenti6n form attached
(if Replacement)
Type # Conn. Type
/ Y /
3/02