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0
OSHKOSH
ON THE WATER
Job Address 1095 N WESTFIELD ST
CITY OF OSHKOSH
No
117258
PLUMBING PERMIT - APPLICATION AND RECORD
Owner EVERGREEN MANOR INC
CreateDate 11/11/2005
Contractor WATTERS PLUMBING
Category 440 - Industrial-Interior
Plan
Bathtub ---.!! Shower 0 Water Softner 0 Wait.SI. 0 Shamp Sink 0
Whirlpool 0 Floor Drain 0 Local Waste 0 Ice Chest 0 FlrlWst Sink 0
Lavatory 0 Lndry Tray 0 Clothes Wshr 0 Exam Sink 0 Catch Basin 0
Toilet 0 Disposal 0 Bidet 0 Sculry Sink 0 Wash Ftn 0
Res. Sink 0 Dishwasher 0 BeerTap 0 Hand Sink 0 Urinal 0
Bar Sink 0 Sump Pump 0 Lab Sink 0 PlasterSink 0 Standp Rec 0
Water Heater 1 Classrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Site Drain 0 Breakrm Sink 0 Dip Well ---.!! F Prep Sink ---.!! Gar Drain 0
Roof Drain 0 Ejector/Grind 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Misc. 0
Fixtures
Coffee Maker ---.!!
Int Grease Trap ---.!!
Ext Grease Trap ---.!!
RPZ Valve 0
Eye Wash Statn 0
Wtr Sewer Mtrs ---.!!
Deduct Meters ---.!!
Wtr Usage Mtrs 0
Use/Nature
ofWork
Install replacement water heater (Debit Account)
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 Parcelld #
0 1608630000
Valuation
$1,190.00
Plan Approval
$0.00
Permit Fees
$20.00 D Permit Voided I
Issued By
Date 11/11/2005
in the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Address PO BOX 118
Agent/Owner
MENASHA
WI 54952 - 0118
Telephone Number
920-733-8125
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.