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OSHKOSH
ON THE WATER
Job Address 3140 BAILEY CT
CITY OF OSHKOSH No 122931
PLUMBING PERMIT. APPLICATION AND RECORD
\ ,
Owner RUSCH HOMES LLC Create Date 11/01/2006
Plan
Contractor SBS PLUMBING LLC
Category 410 - Residential-Interior
2 Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Lab Sink
Sterilizer
Dip Well
Drink Ftn
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature iNSFR /INTERIOR PLUMBING *'debt acct
of Work
3
3
1
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
2 Hose Bibs
Wait. St.
Ice Chest
Exam Sink
Sculry Sink
Hand Sink
Plaster Sink
Surgeons Sink
F Prep Sink
Serv Sink
----,-
Shamp Sink
FlrlWst Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
2 Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
.
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
#
Conn. Type
Parcel Id #
1342950700
$6,350.00 . Pial Approval
(jyn V-J
$0.00
Permit Fees
$140.00 D Permit Void~
Date 12/18/2006
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
Address 4635 RED FOX RD
Agent/Owner
OSHKOSH
Date
WI 54904 - 0000 Telephone Number 920-410-5933
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.
City of Oshkosh
Inspection Services Division
POBox 1130
r--- Osp.kosh, WI 54903-1130
I .:Phone: (920) 236-5050
Fax: (920) 236-5084
DEe 1 8 2006
. DEPARt
Plumblng::~MltmJFf
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~oon
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
.. Application(s) and fee(s) 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 $100.00 plus the
nonnal pennit fee, which ever is greater.
OR
lEe Account S1!$temand hgve adequate funds, check here
i
Job Address ~\t...to
Owner 72t;scll
OSingle Family
",Number of Fixtures:
'2-
Bathtub
Whirlpool
LaVlItory
ToUet
Res. Sink
Bat Smk
Water Heater I
~<:r.J.S 0 E!e.:;t ~t
Shower ...1_
Floor Drain ~1__
Lndry Tray
Lab Sink
3-
--L
-L
Plaster Sink
Sterilizer
Misc.
Fixtures
Date I a.. ks-/o(,.
E>AI.-~"L~ ~"
/lO'fl-v- S
DDuplex
Value (Including labor and materials) C:" ~SZ>'~
Contractor $&S ~~~I,..JL
DMulti-FamUy DRental DCommercial
Disposal
Dishwasher
Sump PUlTlj)
Ejecton'Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrm Sink
Surgeons Sink
Breaknn Sink
Dip Well
Hose Bibs
I
I
-'---
--'-
-Z......
Dlndustrial
DrinkFtn Catch Basin
Wait.St. Wash ftn
Ice Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink Comm. Ice Maker
Serv Sink Site Drain
Int Grease Trap Roof Drain
Ext Grease Trap StandI' Rec 2....-
R.P.Z. Valve Eye Wash 8m
Shamp Sink Wtr Sewer Mtrs
FlrlWst Sink Deduct Meters
Wtr Usage Mtrs
Electric Contractor
OR
DElectric Installation Verification form attached
(If Replacement)
Use I Nature of Work
Conn. Type
1""
!
I
{\ Sanitary Sewer
I Storm Sewer
I
I Water Service
, """"
Size
Material
Type
#