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0
OSHKOSH
ON THE WATER
Job Address 414 DOCTORS CT
Contractor BASSETT MECHANICAL
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
No
118036
OWner AURORA MEDICAL GROUP INC
Category 440 -Industrial-Interior
Create Date 01/20/2006
Plan
Bathtub 0 Shower 0 Water Softner 0 Wai!.S!. 0 Shamp Sink 0 Coffee Maker 0
Whirlpool 0 Floor Drain 0 Local Waste 0 Ice Chest 0 FlrlWst Sink 0 Int Grease Trap 0
Lavatory 0 Lndry Tray 0 Clothes Wshr 0 Exam Sink 2 Catch Basin 0 Ext Grease Trap 0
Toilet 0 Disposal 0 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Res. Sink 0 Dishwasher 0 BeerTap 0 Hand Sink 0 Urinal 0 Eye Wash Statn 0
Bar Sink 0 Sump Pump 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0
Water Heater 0 Classrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0 Deduct Meters 0
Site Drain 0 Breakrm Sink 0 Dip Well 0 F Prep Sink 0 Gar Drain 0 Wtr Usage Mtrs 0
Roof Drain 0 Ejector/Grind 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Misc. 0
Fixtures
Use/Nature
of Work
[Office/ Alterations to convert 6 exam rooms into 4 exam rooms as per plans and disproportionality form submitted. NO STRUCTURAL
HANGES"'check #199178
Size
Material
Type
#
0
0
0
0
0
0
0
0
0
0
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Valuation
$4,700.00
Plan Approval
$0.00
Permit Fees
0
0
0
0
0
$20.00 0 Permit Voided I
Parcelld #
1519110600
Issued By
Date 01/31/2006
In the performance of this work, I agree to perform all work pursuant to rules goveming 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 7000
Agent/Owner
KAUKAUNA
WI 54130 - 7000
Telephone Number 800-236-2502==920-
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.