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Home My WebLink About0123873-Plumbing G~. OSHKOSH ON THE WATER Job Address 103 W 15TH AVE Contractor Bathtub Whirlpool Lavatory Toilet Res. Sink Bar Sink Water Heater Site Drain Roof Drain Misc. Fixtures Use/Nature of Work Valuation Issued By CITY OF OSHKOSH No 123873 PLUMBING PERMIT - APPLICATION AND RECORD HOMEOWNER Owner GERALD M/JILL L STANUCH Create Date 03/21/2007 Category 410 - Residential-Interior Plan Water Softner Wait. St. Shamp Sink Coffee Maker Local Waste Ice Chest FlrlWst Sink Int GreaseTrap 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 Shower 1 Floor Drain 1 Lndry Tray 1 Disposal Dishwasher Sump Pump Classrm Sink Breakrm Sink Ejector/Grind I Md bathroom to 2nd floor. Size Material Type # Conn. Type Storm Water Parcel Id # 0304950000 $2,000.00 Plan Approval $0.00 Permit Fees $25.00 D Permit Voided I Date 03/21/2007 The undersigned, in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the principle residence of the undersigned, hereby acknowledges, per Wisconsin State Statutes, ss 145.06, that other individuals will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing the work involved must be covered by a permit issued to a properly licensed Master Plumber. all work pursuant to rules governing the described construction. .. _ l-of Date? Z Signature Agent/Owner OSHKOSH WI 54902 6511 Telephone Number 920-233-0630 Address 103 W 15TH AVE 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. 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. ~ " .. ~ City of Oshkosh Inspection Services Division POBox 1130 Oshkosh, WI 54903-1130 Phone: (920) 236-5050 Fax: (920) 236-5084 Plumbing Permit Application I hereby apply for a permit 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 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 If YOU are a contractor varticipatinz in the Permit Fee Account System and have adequate funds. check here if you want this processed throuzh your account n Job Address 103 ~v. 15ft, Ave.. Owner (} eVil!! 5 f tthULh ~ingle Family Value (Including labor and materials) 1/,000 , 5r2( -07 Date Contractor ;1JA DRental DCommercial DIndustrial DDuplex DMulti-Family Number of Fixtures: Bathtub Disposal Drink Ftn Catch Basin Whirlpool Dishwasher Wait.St. Wash Ftn Lavatory -L Sump Pump Ice Chest Urinal Toilet .-L Ejector/Grind Exam Sink Gar Drain Res. Sink Water Softner Scu]ry Sink Soda Disp Bar Sink Local Waste Hand Sink Coffee Maker Water Heater Clothes Wshr F Prep Sink Comm. Ice Maker Gas 0 Elect 0 PwrVnt Bidet Serv Sink Site Drain Shower Beer Tap Int Grease Trap Roof Drain Floor Drain Classrm Sink Ext Grease Trap Standp Rec Lndry Tray Surgeons Sink R.P.Z. Valve Eye Wash Stn Lab Sink Breakrm Sink Shamp Sink Wtr Sewer Mtrs Plaster Sink Dip Well Flr/Wst Sink Deduct Meters Sterilizer Hose Bibs Wtr Usage Mtrs Misc. ~ hl/jl/(jJfJ?tfj>tl~e.. baf~/()? .IJ/;{ / OR DElectric Installation Verification form attached (If Replacement) Fixtures Electric Contractor Use / Nature of Work J1 e Iiv h4f~'()(Jm Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service 11/05