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OSHKOSH
ON THE WATER
Job Address 452 W 5TH AVE
Contractor KURT ZENTNER & SONS INC
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner ROYDONITHERESA FAHLEY
Category 411 - Residential-Water Heaters
Bathtub Shower Water Softner Wait. St. Shamp Sink
Whirlpool Floor Drain Local Waste Ice Chest Flr/Wst 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 / GAS WATER HEATER REPLACEM~NT "debt acct
of Work
No
123401
Create Date 0210212007
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 $~Q
Issued By CZ5Yn
Plan Approval __$O._~Q
$25.00 0 Permit Voided I
Parcel Id #
0905110000
Permit Fees
Date 02102/2007
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 2860 OREGON ST
Agent/Owner
OSHKOSH
WI 54902 - 0000 Telephone Number 235-1340
Date
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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.
Mar. 23. 2006 9: 16AM
ins p.e ct ion s e r vie e s
No.5819 P. 1
_ City of Oshkosh
Inspection Services Di~sion
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
~
OJHKOfH
ON THF WAT"R
Plumbing Permit Application
1 hereby apply for a permit to do and inslall 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 fcc(s) can be brought to City Hall, Room 205 Of 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
nonnal permit fee, which ever is greater.
OR
If'iou are a. con(ra~tor '(!arficiv.atinf in the Permit Pee Account System and have adequate funds. check here
ifv()u want this 1Jrocessed throUfh vour atcount f\Y ,
Job Address.J15~ W', f)~ ~
Owner ~..e(\ ~h\RJ
IYJSingle Family DDnplex
Value (Including labor and materials) -fl~OO. Ct> Date m/?1:>JD'
Contractor \(\)~T li(rh1P,(f~!; ~L
DMulti-FamDy DRental . DCommercial Ondustrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
T011et
Res. Sil1k
DatSiIlk _
Water Heater -1-
. J( Gas 0 meet 0 I'wrVnt
Shower
FIuorDrain ._
Uldty Tray
Lib Sink
Pla5tcr Sink
SteriJizm-
---
Disposal
Dishwasher
Sump .Pump
EjeetotfGrind
Walcr Sottnet
Local WlISte
Clulht:l; Wlbr
Bidet
Beet Tap
ClaasnnSink
SurgeunsSink
Bn.aIamSink
Dip Well
Hose Bibs
Dr1nlc rtrl
Wait.St.
.Iee CheSt
&am Sink
Sculry Sink
Hand Sink
P Prep Sink
Scrv Sink
Int oreasc Trap
Ext Grease Trap
R.P.z. Valve
Shamp Sink
Flr/Wst Sink
Caleh Buin
Wul1Ftll
Urinal
Oar Drain
Soda Disp
Coffee Maker
Comm. Ice Milker
Site Drain
RoofDtaln
Standp RIle
Eye Wash Sill
WlrSowIlrMers
Deduct Melenl
Wtr UllIIgc Mtn;
.Milia.
FixtuTcll
Electric Contractor
OR []Electric Installation Verification form attached
(lfReplacement)
Use I Nature of Work ~{ lttt.lR{ (ir\I,JIU ~l\-;\-
Size
Material
Type
#
Conn. Type
Sanitary Sewer
StOmt Sewer
Water Service
11/05