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OSHKOSH
ON THE WATER
Job Address 500-550 S KOELLER ST
Contractor JIM'S PLUMBING & HEATING INC
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
No 123474
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Lab Sink
Sterilizer
Dip Wen
Drink Ftn
Owner RIVER VALLEY ONE LLC
Create Date 02109/2007
Category 440 - Industrial-Interior
Plan X1-232-0107-P
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
UselNature PACE 550 1 Interior storm roof drain conversion and completion of 'Verizon" tennant space interior1'h..imbing. Work in addition: to permit.
of Work 122841 *** Debit Account ')f '/;
Valuation
Issued By
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
6 Ejector/Grind
4 HOSE BIBB
Sanitary Sewer
Storm Sewer
Water Service
$17,500.00 Plan Approval
Size
Wait. St.
Ice Chest
Exam Sink
Sculry Sink
Hand Sink
Plaster Sink
Surgeons Sink
F Prep Sink
Serv Sink
Material
$0.00 Permit Fees
Shamp Sink
FlrlWst Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain,
Soda Disp
:~ ", .
Type
#
Conn. Type
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
PClrcelld #
0611620000
Date 02/09/2007
$77.00 D Permit Voided I
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 W6166 GREENVILLE DR
Agent/Owner
GREENVILLE
Date
WI 54942 - 0000 Telephone Number 920-757-5258
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.
~0~/16/2~07 09:43 FAX 920
::: City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh. WI 54903-1130
Phone: (920) 236.5050
Fax: (920) 236-5084
757 6482
JIM'S PLt1:MBING
I4J 001/001
~.
OMKOJR
ON nH; W^TER
Plumbing Permit Application
1 hereby apply for a permit to do and install the followiDg plumbing on the prexnisos hereinafter described. ~owork to comorrn to the
Wisconsin State Plumbing .Code, in the pmonnance of which aU'parties hereto agree to and are bouIid by said stat'll.tes.
. 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
ou 'are a contractor artici atin in the Permit Fee Account tem and.haye: tJde eck here
ou want t is roce sed t 0 hour accouni
'JobAddress 5lJO )~ k~ Value (Includinglabor<tndmatmals) :/I / ~,~ ....Date I//(p/a/
Owner 4U,~u- Il~~ Contractor -::r;~ I'/~ ' (.I'I ":'
DSingle Family . ODulllex. DMulti~Family ORelltal J8)Comin~r.tial QIn"i1-ustr.i~r: :', ~: ~ .:, :
Number of FixtUres:
Ba thtub Dispos.al
Mi\rl~l ~ Dishwasher
Lavatory Sump Pump
Toilet ~j ector/Grind
Res. Sink Water Soflner
Bar Sink I..oeal Waste
Water Heater Clothes Wshr
o Qas 0 Elect 0 PwrVnt Bidet
( Shower -'-0 Beer Tap
floor Drain Clamm Sink
Lndry Tray SUfsc:ons Sink
Lal;l Sink - Brealam Sinle
PI<'lster Sink Dip Well
Sterilizer Hose Bibs
Misc.
'FixLureS
Electric Contractor
:~,; ~~ ;':' ~, :,-:" ;., ~ ~::.:: :,,~; r .;, .:::
Drink Fb1
Wail. SI.
Ice Chest
Exam Sink
Sculry Sink
Hand Sink
F Prep Sink
Sm-' Sink
Inl Gre:lse Trap
Ext Grease Trap
R_P 2. Valve
~(j)
..(
.;
Catch Basin
. Wash Fm
Urinal
Gar Drain
. Soda Disp
Coffee Maker
Carom. lee Maker
-:IJJ:.. Shamp Sink t ~Il
OJ Flr/WstSink ) DeductMeters
Z - I 1()Il
-L~ I ! Wtr Usage Mtrs
, I t:-.. (l(o,l\ ..:J t/er;c.o,., J ui/Uf/t;V'}
OR DElectric' Installation Verification form attached
(If Replacement)
Site OrRin
RoofDnain @ ~
Standp ~cc
Eye Wash Sin
Wtr Sewer Mtr.s
Use / Nature of Work
Water Service
.
. . tf u1&-rf
__ /,t uVl'" (j)
/ .f~""./ J
je...)>J 0 / rY.,v~'" .f
51 A r-~~J ~
:J7 _/wJ /')- J-
,1" ; ~ nlos
/10'> I
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewc:r