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OSHKOSH
ON THE WATER
Job Address 1210 MORELAND ST
CITY OF OSHKOSH
No
123392
PLUMBING PERMIT - APPLICATION AND RECORD
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature 'SFR / REPLACE DISHWASHER FOR SEARS **check #14968
of Work
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner TIMOTHY J JACKSON Create Date 0210212007
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 RAPID SOFT LLC
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
P~lrcelld #
1 ~108930000
$923.00 Plan Approval
$0.00 Permit Fees
$25.00 0 Permit Voided I
Valuation
Issued By 'VYYl v._)
Date 02/0212007
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 Date
Agent/Owner
Address N1284 CRANDON CT
GREENVILLE
WI 54942 - 9750 Telephone Number 757-6130
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
~
OII--fKOJH
ON THE WATER
Plumbing Permit Application
I hereby apply for a pennit 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 1 T28,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
nonnal permit fee, which ever is greater.
OR
l~ ;011 ore 0 contractor par/icina!in/! in the Permit Fee Account System and have adequate funds. check here
i ou want this processed throu~h your account n
Job Address / c;J /6 1/]1"'10 r--e /_~-p k Value (Including labor and materials) c:;7;;> S'. C>cJ
Owner (3, -",cf/"(./ Contractor 1~,4"fi.kJ f2.r- L-? c
pgsingle Family DDuplex DMulti-Family C]RentalDCommercial
Date / /:?o/tf":>
,
[]Industrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
o Gas 0 Elect 0 PwrVnt
Shower
Floor Drain
lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Lndry Standp
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Soflner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classnn Sink
Surgeons Sink
Breakrm Sink
Dent. Oper. Shamp Sink
Dip Well FlrlWst Sink
---L Drink Ftn Catcb Basin
Wail. St. Wash Ftn
lee Chest Urimll
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink COm,.e Maker
F Prep Sink Ice Maker
Serv Sink Site ()rain
lnt Grease Trap Roof Drain
Ext Grease Trap Standp Rec
Use I Nature of Work
t-ylcc-c
DElectric Installation Verification form attache
(lfReplacement)
D;r /.... (--,:J-~ L-..r ;z;",,-- S ~ '\
Electric Contractor
OR
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Stonn Sewer
Water Service