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OSHKOSH
ON THE WATER
Job Address 1112 DOVE ST
CITY OF OSHKOSH
No
119704
PLUMBING PERMIT -APPLICATION AND RECORD
Contractor
HOMEOWNER
Bathtub 1 Shower 1 Water Softner
Whirlpool Floor Drain 1 Local Waste
Lavatory 2 Lndry Tray Clothes Wshr
Toilet 2 Disposal Bidet
Res. Sink 1 Dishwasher 1 Beer Tap
Bar Sink Sump Pump 1 Lab Sink
Water Heater 1 Classrm Sink Sterilizer
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Breakrm Sink
Ejector/Grind
3 rose bibb
ddition to home and remodel existing structure.
Dip Well
Drink Ftn
Owner JOSEPH G DUTSCHECK
Create Date OS/25/2006
Category 410 - Residential-Interior
Wait.St.
Ice Chest
1 Exam Sink
Sculry Sink
Hand Sink
Plaster Sink
Surgeons Sink
F Prep Sink
Serv Sink
Shamp Sink
FlrlWstSink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
Plan
Coffee Maker
Int GreaseTrap
Ex! Grease Trap -
RPZ Valve
Eye Wash Statn
2 WtrSewerMtrs
Deduct Meters
Wtr Usage Mtrs
Size
Storm Water
Material
Type
#
Conn. Type
Valuation
$3.000.00 Plan Approval
$0.00
Parcelld #
1601470000
Issued By
Permit Fees
$126.00 D Permit Voided I
Date OS/25/2006
The undersigned, in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the
principle residence of the undersigned, hereby acknowledges, per Wisconsin State Statutes, ss 145.06, that other individuals
will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing
the work involved must be covered by a permit issued to a properly licensed Master Plumber.
In the perfonnance of this work, ~ree to ~ work pursuant to rules goveming the described construction.
Signature ~ ~ Date Y-2Çrc:?:?Ç:
/ AgenUOwner
Address 1112DOVEST
OSHKOSH
\^.II. 54902 3304 Telephone Number
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 receiyed. Work may
continue if the inspection is not perfonmed within two business days from the time the project is ready.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a pany, if you perform the work
described in this permit application within an easement, the City strongly urges the penmit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.