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OSHKOSH
ON THE WATER
Job Address 1960 EVANS ST
CITY OF OSHKOSH No 122883
PLUMBING PERMIT - APPLICATION AND RECORD
Owner CHARLES A1MARIL YN J PERRY Create Date 12/13/2006
Plan
Contractor KOCH PLUMBING
Category 411 - Residential-Water Heaters
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest FlrlWst Sink
Lndry Tray Clothes Wshr Exam Sink Catch Basin
Disposal Bidet Sculry Sink Wash Ftn
Dishwasher Beer Tap Hand Sink Urinal
Sump Pump Lab Sink Plaster Sink Standp Rec
Classrm Sink Sterilizer Surgeons Sink Ice Maker
Breakrm Sink Dip Well F Prep Sink Gar Drain
Ejector/Grind Drink Ftn Serv Sink Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Multifamily/ Apt #4 - Replace gas water heater. **DEBIT ACCT**.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1514819706
Valuation
Issued By
$600.00 Plan Approval
~
$0.00 Permit Fees
$25.00 0 Permit Voided I
Date 12/13/2006
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 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
AgenUOwner
Address 2005 DOTY ST
OSHKOSH
WI 54902 - 0000 Telephone Number 920-231-66610r235
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.
ic 13 06 02, 15~
City of Oshkosh
... Inspection S~rvices Division
POBox 1130
f"Oshkosh, Wl54903-1l30
Phone: (920) 236.5050
Fax: (920) 236-5084
Clarence Koch
(820) 235-0282 p.l
~
OJHK01H
ON THE WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter descn"bed, the work to conform to the
Wisconsin State Plumbing Code, in the performance ofwbich all parties hereto agree to and are bound by said statutes.
. Application(s) and feees) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If vou are a contractor Darticipatinrz in the Permit Fee Account System and have adequate funds. check here
if ~ou want this processed throu!!h your account n .. . -
J:f4
Job Address ;r?6tP Et/,4/i/J~ s"r'" Value (Including labor and materials) ~F"'" Date /Z-15-()(,
Owner (J/Jtt'fi?/~..r {'~V'.IE Contractor /CPC# P~t:Y#?/.Jt/~6
DSingle Family DDuplex QgMulti-Family ~Rental DCommercial Dlndustrial
r Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater --'-
)(bas 0 Elect 0 PwrVnt
ShoWer
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
Fixtures
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrm Sink
Surgeons Sink
Breakrm Sink
Dip Well
Hose Bibs
Drink Fm
Wait.; St.
Ice Chest
Exam Sink
Sculry SiIlk
Hand Sink
F Prep Sink
Serv Sink
IntGreaseTrap
Ext Grease Trap
-. R.P.Z.. Valve
Shamp Sink
Flr/Wst Sink
Catch Basin.
Wash Ptn
Urinal
GaT Drain
Soda Disp
Coffee Maker
Comm. Ice Maker
Site Drain
Roof Drain
Standl' Rec
Eye-WashStn-- -.. _ --=--
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
OR . DElectric Inst3nation VerificatioD form attached
(If Replacement)
Electric Contractor
Use I Nature of Work l?5~?-4C/Z:' ~rC3/z., /-I/z'/4P5L.
Size Material Type # Conn. Type
~tp
\J\-j \ 7! 19
rt \:i ~~
, 1~
\
Sanitary Sewer
\
Storm Sewer
Water Service
11./05
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