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OSHKOSH
ON THE WATER
Job Address 1930 OMRO RD
CITY OF OSHKOSH No 122944
PLUMBING PERMIT -APPLICATION AND RECORD
Owner B & G REALTY INC Create Date 11/15/2006
Plan
Contractor J RASMUSSEN PLUMBING INC
Category 440 - Industrial-Interior
Bathtub Shower Water softner Wait. St. 3 Shamp Sink
-
Whirlpool Floor Drain Local Waste Ice Chest 1 FlrlWst Sink
Lavatory Lndry Tray Clothes Wshr Exam Sink Catch Basin
Toilet 2 Disposal Bidet sculry Sink 1 Wash Ftn
--------
Res. Sink Dishwasher Beer Tap Hand Sink 2 Urinal
Bar Sink Sump Pump Lab Sink Plaster Sink standp Rec
Water Heater Classrm Sink Sterilizer Surgeons Sink Ice Maker
--
Site Drain 3 Breakrm Sink Dip Well F Prep Sink Gar Drain
Roof Drain Ejector/Grind Drink Ftn serv Sink Soda Disp
Misc. 5 Glass Filler,Steam Table,OJ Disps,Potato Peeler
Fixtures
Coffee Maker 2
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Restaurant /Interior alterations to Waitress Station, Hostess Station, Customer Seating Counter, restrooms and other misc. alterations as
described on the contractor scope of work. "Debit acet
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
I
Water Service
Parcelld #
1610970000
Use/Nature
of Work
Valuation
Plan Approval _____ $0.00
Permit Fees _~!~~2Q 0 Permit Voided I
_~!Q,000.00
Issued By
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
Address 1914 GREENBRIAR TRL
- ---
Agent/Owner
OSHKOSH
WI 54904 - 0000 Telephone Number 920-233-6747
Date 12/19/2006
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.
o
City of Oshkosh
Inspection Services Division
POBox 1130
()shkosh, VVI 54903-1 130
Phone: (920) 236-5050
Fax: (920) 236-5084
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Plumbing Permit Application
I bereby apply for a perroit to do and install the foHowin~ plumbing on the premises hereinafter described, the work to conform to the
VVisconsin State Plumblng Code, ill the perfonua.nce ofwbich aU parties hereto agree to and are bound by said statutes,
. Applicatioo(s}and fee(s} can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Dsbkosh WI 54903-1128. Commencing work without pennit(s) will result in fees heing doubled or $100.00 plus the
~:: ~::t,;~,::::::~:~:~~eJ'ermll F L:Sy.tl=~~yave ade.ualw.dg~ check her<
if \IOU want this vrocessed thrQug'h }lour aCC01il1L~..!if.QQ1
Job Addr.ess~~E_J) fI\,-R.~ _ f-a ___
Owner .'.1:.l~-~- t~J +CA.AI\.~_ C&ntractoJr
DSingle Family DDuplex DMulti-Family
_ Value {Including labor and 111~tC"i~)S),__Lp f binl_~.~~ Date.. '" - / 3 ...b'
:r. e. ~S ~V\ U. SSE:,J P 1 'h ::J:. {'J e-. .
--~--,.._~...._---,------~-~
DRen.t:al )81C~mamercial DIndustrial
Nu.mber o:fFixtures:
~-_.-
.Di5p08~ J
Disbwasher
Sump Pump
f\icctor/Grind
Warel' Sow(.'1"
Local Waste
Clotlles Wshr
Bidet
_.J__
Drink Flu
Wait.St.
lee ChCllt
Exam Sink _
Sculry Sink
Hand Sink
F Prep Sink
Scrv Sink
._.~._--
_ __1..__
Catch Basin
Wash Ftn
Urinal
r,
Bailitub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
u Ga.q LI Elect U PwrVnt
'". G,lrDl'llin
.__1.._..
.__.;),--
H__L.__
Soda Disp
Olffec Mak(,r
Comm. lee Maker
Site Droiu
--1---
4-.
1
_~3
Sterilizer
Miac.
Fixtures
Beer Tap In! Grease Trap Roof Drain
Classrm Sink Clet Grease Trap Stalldp Rec
Surgeons Sink R.P.Z, Valve Eye Wash SOl
Bl'eJlkrm Sink Sharnp Sink Wtr Sewer Mtxs
Di]> Well _.L.._ FlrlWst Sin!< Deduct Me11:rs
Hos," Bills Wtr Usage MU's .---
_~-~Jgjj ji~~!LT;:I~~of~i:t~~t~~~~~~ f:.::;:,-?t~
(If R('placcmcnt)
Shower
Floor Dr~in
Lndry Tray
Lab Sink
PlasUlf Sink
Electrle Cttntrador
Use / Nature ofWQrk____._&(U~,,:W
_.l~
-----t----.---..-~-..----...----
-----------.---s;.~..-.---.--.----- M~t;;;J-.-----Typ;-.-.-.--#-.-"..-.--C:~~~:-.;ryp;.-
Sanitary Sewer
Stonn S(;.,'Wer
",
____-.----......--.~.,,_...~-.------..----,...-------..~.--.---.__._u_._.__...._.:__.__._........_.___..._..._.._.'n__...__..._.A'._'_'___."
Water Service
1l./05