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OSHKOSH
ON THE WATER
Job Address 1009 BOWEN 5T
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner CHARLES/RUTH ISAACSON
Contractor M P KELLY
Category 411 - Residential-Water Heaters
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
UselNature
of Work
Valuation
Issued By
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Lab Sink
Sterilizer
Dip Well
Drink Ftn
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
No
123317
$0.00 Permit Fees
$25.00 0 Permit Voided I
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
SFR / REPLACE GAS WATER HEATER **check #8317 - , .
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1109500000
Address 665 N MAIN ST
Agent/Owner
OSHKOSH
WI 54901 - 4431 Telephone Number 231-1750
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
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
RECEIVED
ce
OJHKOJH
ON THE WATER
JAN 26 2007
DEPARTME~T Of.
Plumbing ~1~f~RT
I hereby apply for a pemrit 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 andareboUIld by said statutes.
. Application( s) and fee( s) can be brought'to City Hall, Room 205 orm,ailed to Inspection Services, PO Box .1128,
Oshkosh WI 54903-1128. Commencingwork withoutpermit(s} will result in fees being doubled or $100.00 plus the
normal permiHee, which ever is greater.
OR
Ifvou are a contractor particivatingln the Permi.! Fee AccountSvstem and have adequate funds. check here
i ou want this rocessed throuh our account .
J~b Addre1i&:J!;~ Value <mo'"",g ,...,... "".""".l1t! ~ PI
~er _ _:oiC>tt@S.~ Coutractor ~.~. ~t' . --'
tASlugIe Family DDuplex DM1!iti-Family DReutalDCo er"ial
Date '/&i~'
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Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water jjeater i-
~as 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
Breaknn Sink
Dip Well
DrinkFtn
Wait.St.
Ice Chest
Exam Sink
.S.clilry Sink
l-lan4!~j~~
FPrep Sink
Serv Sink
IntQrease Trap
ExfQrease Trap
RP .Z. Valve
S,hamp Sink
Flr/WstSink
Catch Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Ice Maker
Site Drain
Roof Drain
Standp Rec
Eye WashStn
Wtr SewerMtrs
Deduct Meters
Wtr Usage Mtrs
I ... .......
OR OElectric Installation Verification form attached
- (If Replacement) . . ...
S-tJ tI
Electric Contractor
Material
Type
#
Conn. Type
Use I Nature of Work
Sanitary Sewer
:StonnSewer '
Water Service
P. s./
4/05