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OSHKOSH
ON THE WATER
Job Address 1237 LIBERTY ST
CITY OF OSHKOSH
No
123333
PLUMBING PERMIT - APPLICATION AND RECORD
I
1
1
1
1
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner LOIS P/PATRICIA C HODGELL LIFE ESTATE Create Date 01/03/2007
Category 410 - Residential-Interior Plan
Water Softner Wait. St. Shamp Sink Coffee Maker
Local Waste Ice Chest FlrlWst Sink Int Grease Trap
Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
Bidet Sculry Sink Wash Ftn RPZ Valve
Beer Tap Hand Sink Urinal Eye Wash Statn
Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Sterilizer Surgeons Sink Ice Maker Deduct Meters
Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Drink Ftn Serv Sink Soda Disp
Contractor KOCH PLUMBING
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
SFRI Remodeling the kitchen and bathroom". The 2nd floor bathroom and the kitchen will be gutted and redrywalled and insulated. ""debt
acct
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1203680000
. $7,000.00) Plan Approval
fuyJL~
$0.00
$35.00 0 Permit Voided I
Permit Fees
Date 01/26/2007
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
Agent/Owner
Address 2005 DOTY ST
OSHKOSH
WI 54902 - 0000 . Telephone Number 920-231-6661 or 235
To schedule inspections please call the Inspection Request line at 236-5128 ~oting 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.
~ ..n 26 07 01'11.
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
.. Clarence Koch
(920)
I
235~0282 p.l
~
OIHKOJH
ON THE WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter desCrIbed, the work to conform to the
WisconsiJ;1 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
normal permit fee, which ever is greater.
OR
u re a contractor artici atiner in the Permit Fee Account S stem and have ade uate unds check here
i ou want this rocessed throu h vour account
Job Address /Z3 7 LI8L:~/'*, Value (Includmg labor and mater.ials) ~ tJCJO ~- Date 1- Z. ';'-07
L'l ,I 'A ,.../ C 1//"1 .- I' / ;:;.l.., /._y:. J J.' .. . ' .'
Owner ,..47l2,.t:..l/J />419,."6/.:;;,, ontractor I( ~~I't. ,. ~_W,r"'';;''/;~'',:"r.,~
~ingle Family ODuplex DMulti-Family DRental DCommerciaI OIndustrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
---'-
I
---,-
I
Bar Sink
Water Heater -1-
o Gas ,t!Elect 0 PwTVnt
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
Fixtures
Electric Contractor
Use I Nature of Work
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Sonner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classnn Sink
Surgeons Sink
Breatam Sink
Dip Well
Hose Bibs
DrinkFtn
Wait. St.
lee Chest
Exam Sink
ScuJry Sink
Hand Sink
FPrepSink
SeIV Sink
Int Grease Trap
Ext Grease Trap
-.RP.Z.Valve'" .-.
Shamp Sink
FtrfWst Sink
Catch Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Comm. Ice Maker
Si re Drain
Roof Drain
Standp Rec
EyeWash-Stn.
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
OR . DElectric Installation Verification form attached
(If Replacement)
."
I {'~'~ / ;~:,~{~!~':: .:~.~~:;i-~~,~ ;;.," ~ f~:S~:1; l"-'f~:~~r.
/
CoIllL Type
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
#
.
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