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OSHKOSH
ON THE WATER
Job Address 1020-1142 S KOELLER ST
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner KOELLER ONE LLC
Contractor J RASMUSSEN PLUMBING INC
Category 440 -Industrial-Interior
Bathtub 0 Shower -.----2 Water Softner 0 WaitSt 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 -.----2 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 -.----2 Lab Sink 0 PlasterSink 0 Standp Rec 0
Water Heater 0 Classrm Sfnk 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Site Drain 0 Breakrm Sink 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
Roof Drain 0 Ejector/Grind -.----2 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Misc. 5 PEDICURE CHAIR STATIONS
Fixtures
No
118601
Create Date 03/22/2006
Plan
Coffee Maker -.----2
Int Grease Trap -.----2
Ext Grease Trap -.----2
RPZValve 0
Eye Wash Statn 0
Wtr Sewer Mtrs 0
Deduct Meters 0
Wtr Usage Mtrs _JI
Use/Nature
ofWork
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Size Material Type # Conn. Type
0
0
0
0
0
0
0
0
0
0
Sanitary Sewer
Storm Sewer
Water Service
Valuation
$3,000.00
$0.00
$35.00 D Permit Voided I
Permit Fees
Plan Approval
Issued By
Date 03/22/2006
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 parfy, 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
Address
1914 GREENBRIAR TRL
AgenUOwner
OSHKOSH
WI 54904 - 0000
Telephone Number
920-233-6747
Parcelld #
1308490000
Date
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.
£13/22/2£1£15 £17: 33
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2335747
J RASMUSSEN
Rasmussen Plumbing, Inc.
. .
Phone (920) 233-6747
Fax (920) 231-1289
E-mail address - rasmlJss@che.rter.net
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Jeff Rasmussen
Master Plumber #22325 J
J 914 Greenbriar TraU
.-2.shkosh, WI 54904-8887
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