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OSHKOSH
ON THE WATER
Job Address 2553 VILLAGE LN #A
CITY OF OSHKOSH
No
123637
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner VERNON G GAUGER REV TRUST Create Date 02128/2007
Category 411 - Residential-Water Heaters 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 KOCH PLUMBING
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature Multifamily / Replace electric water heater. EIV provided by Cumings Electric. **DEBIT ACCT**.
of Work
Valuation
Issued By
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1321080000
$150.00 Plan Approval
$0.00 Permit Fees
$25.00 D Permit Voided I
~.
Date 02/28/2007
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address 2005 DOTY ST
OSHKOSH
WI 54902 - 7040 Telephone Number 920-231-6661 or 235
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
."'b 28 07 10: 44a
:;:b 2B D7 lU:1::>a
:::'
Clarence Koch
cumlngsclecerlc Inc
(920) 235-0282
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Cit)' oro.llkOf.h
Di..uioa ofla:spe<:liOl\.$nvicn
21$ ClJlnb A~I"1I<
PO Belt llJO .
OslIkodl wt :14901-1 130
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Electric Installation VerificatioD
I (We)
COKIHGS ELEC'DUC INC.
(Electrical Contractor Name)
P 0 .BOX 749. HEE!WI. WI 54957
(Address) (City)
(State)
(ZIp Code)
have been contracted to perform electric installation work: for
VERN GAUGER
(Name ofpartyoontracted to)
at the following address:
2553 VILLAGE LANE
(Address where work will be penormcd)
The nature of the worle consists of: (Check One or Describe the Nature of Work:)
Rccbooection or new circuit fo~ replacement Heating Plant and/or Ale Condenser.
--X- Reconnection or new circuit for replacement Electric Water Heater or power vco.ted
water heater.
Reoonnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding /soffit installation. Note: New Se:tVice
Entrance Cables win require a separate permit.
ReconncctioIl or new circuit for the replacement of other permanently wired
appliances I fixtures.
New circuit for the addition of Ale to an in4ividual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ 85.00
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection I installation will be done in compliance with manufacturer and Electric code
requirements.
JUCHARD .J VERZEL
(print Name of Officer)
2/2B/07
(Date)
W2
~)C
2-20-07
~'b 28 07 08:55a Clarence Koch
y
X ~ City of Oshkosh
-:- Inspection Services Division
POBox 1130
Oshkosh, \v'I 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
(920) 235-0282
p. 1
~
OfHKOfH
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 ofwmch aU 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 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal pennit fee, which ever is greater.
OR
J au are a contractor artici atin in the Permit Fee Account Svstem and have ade
i(vou want this orocessed throuf!h your account Q(l
t/ It! IT
Job Address2~S-S f/;(.lll-WZ:: LA.
Owner I/c,;!A/' a A-~r~..
DSingle Family DDup]~x
A-
I <""" r') e
Value (Inclucing labor and materials) ..; (/
Contractor /::'oc/./' ~~t;;,
DMulti-Family DRental DCommercial
DateZ-Z~-OI
OIndustrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Disposal
Dishwasher
Drink Ftn Catch Basin
Wait.St Wash Fm
lce Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp ~
Hand Sink Coffee Maker
F Prep Sink Comm. Ice Maker
Serv Sink Si Ie ~ain
Int Gre3Se Trap Roof Drain
Ext Grease Trap Slandp Ree
RP.Z. Valve Eye Wash Stn
Shamp Sink Wtr Sewer MtTS
FlrlWst Sink Deduct Meters
Wtr Usage Mtrs
Res. Sink
Bar Sink
Wate.- Heater I
o Gas;(Elect 0 PwrVnt
Shower
floor Drain
Sump Pump
Ejector/Grind
Water Softner
Local W.aste
Clothes V.'shr
Bidet
Beer Tap
Classnn Sink
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
Fixtures
Electric Contractor IV~H~b5
Surgeons Sink
Breaknn Sink
Dip Well
Hose Bibs
~ DElectric Installation Verification form attached
(If Replacement)
Use / Nature of Wark ;ec-/lI'~AC/C .k/ ,47 /.:::~.. H t,:f" ~ T e-,A!..
Size
Material
Type
#
Conn. Type
Storm Sewer
Jj~1J
. 1
1]
~
Sanitary Sewer
\Vater Service
11/05