HomeMy WebLinkAbout0123322-Plumbing (toilet)
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OSHKOSH
ON THE WATER
Job Address 1711 NORTHPOINT ST
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner RAYMOND M SIMONS TRUST
Contractor M P KELLY
Category 410 - Residential-Interior
Bathtub Shower Water Softner Wait. St. Shamp Sink
Whirlpool Floor Drain Local Waste Ice Chest FlrlWst Sink
Lavatory Lndry Tray Clothes Wshr Exam Sink Catch Basin
Toilet Disposal Bidet Sculry Sink Wash Ftn
Res. Sink Dishwasher Beer Tap Hand Sink Urinal
Bar Sink Sump Pump Lab Sink Plaster Sink Standp Rec
Water Heater Classrm Sink Sterilizer Surgeons Sink Ice Maker
Site Drain Breakrm Sink Dip Well F Prep Sink Gar Drain
Roof Drain Ejector/Grind Drink Ftn Serv Sink Soda Disp
Misc.
Fixtures
Use/Nature FR / REPLACE TOILET **check #8317
of Work
No 123322
Create Date. 01/26/2007
Plan
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Size
Conn. Type
Material
Type
#
Sanitary Sewer
Storm Sewer
Water Service
Valuation
$500.00 Plan Approval
CZ5YnW
$0.00 Permit Fees
$25.00 0 Permit Voided I
Issued By
Parcelld #
1514580000
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
Address 665 N MAIN ST
..... .... n
Agent/Owner
OSHKOSH
WI 54901 - 4431 Telephone Number 231-1750
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.
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903.,1130
Phone: (920) 236-5050
Fax: (920) 236-5084
ECEIVED
.@,~,,,,,,,,.,,,,,,,.,,,,,,,,.',',,",':
~
OJR~()JH
; ,ON THE W^TE~
JAN 2 6 ?O(\7
, "DEPARTMENTOF
COMMUNITY DEVELOPMENT
Plumbing 'PermU.Ap:pUc.ation
I hereby apply for, apert1,lit to do and instaUthe foltowingplumbirtg onthe.ptenuseshereinafterdescn'bed,tbe woikto confonnto the
Wisconsin State PtwnbingCode, in the performance of which allpartiesher-eto~eetQ and,are'boun:d bysaidstatute.s.
. Application(s) and fee(s)can be brought'to CityHall~Roorn:.205 Qrrilailed to Inspection'Servic:es;POBo~1128,
Oshkosh WI 54903-1128., Commencing work wiihoutpennit(s)willresultin fees being doubled or $100.00 plus the
normalpetmiHee, which ever is greater. -
OR
If vouare a contractorvarticipating,in the Per.init .Fee AccounLSvstemaful havetidequat,efunds, check here
if you want this processed throuf!hvour acc,ount n ,'.' "
, ' ,
Job Addre$s_\ -, '\ ,JO~ 9+'~-+ ',' Value (InCIUdinglabOrandn1:ltetiali;)~..500~ " , Date J j:t~i~tl
OW:gleFanilly~ ~~~ DM':,::;or D~~~~~ ':"'OltJd~~:':~
~'"::~,,--_,,~j:",,.~.:.:.~~:..,_~lj
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
o Gas 0 ElectOPwrVnt
......;.....;,.
DrinkFtn
Wait. St.
Ice Chest
,Exam Sink
~~\I~Sink ,
,I4~!;\~*"~~~';> '
F'PrepSlhk
.$ervSlnk
'Ih~,qrell~e Trap ,
',13xf:Of~settap. "
R.P,Z:Vatve
.~liamp:S1nk '
,'iFltlWstSink
~
Catch Basin
Wa~hFtn
Urinl\1
Gar Drain
,Soda Pisp ,
Coffee Maker
'Iell Mllk,er
Site Drllin
RlXlf prain
Startdp Rec
Bye Wash S\n
Wtr Sewer'Mtrs
Peduc;t Meters
WtrUsage Mtrs
\
: Disposal,
" Dishwasher
Sump Pump
Ejector/Gritid
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
ClassMriSink
, Surgeon$Sink
Breakrm Siftk
Dip Well
.~
~
"'~
.~.
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
, Fixtures
, ...---
"'---
Electric Contractor
Use INature ofW<>rk ~~
". . " .
OR ',', :O~rectri~,;In~t~lla'ti~l1VerifieatiPDcf()tm att!lched
. ~i- . .(It"",,,.,_)
SiZe
Material ' '
type
#
..Cortn..Type"
Sam~ S'ewer
',r;8tol'111:SeW,er:/ .
;p/
'. w,ater:Service
. ....
4/05