HomeMy WebLinkAbout0097482-Plumbing (toilet & lav)
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OSHKOSH
ON THE WATER
Job Address 526 MADISON ST
CITY OF OSHKOSH
No 97482
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JERROD R/DENISE JOSEPHSON
Create Date 09/24/2002
Contractor M P KELLY
Category 410 - Residential-I nterior
Plan
Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
- - - - -
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 1 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
- - - - -
Toilet 1 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FlrlWst Sink 0 Int Grease Trap 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap ---.2.
- - - - -
Bar Sink 0 Dishwasher 0 Beer Tap 0 Sculry Sink 0 Wash Ftn 0
-
Water Heater 0 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
- - -
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
- - - -
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature RENTAL! Replace toilet & reconnect lav/vanity.
of Work
Size
Material
Type
#
Conn. Type
Sanitary Sewer
o
o
o
o
o
Storm Sewer
o
o
o
o
o
o
o
o
o
o
Water Service
Valuation $370.00
Issued By \Z'JV\
Plan Approval
$0.00
Permit Fees
$20.00
Date 09/24/2002
D Permit Voided I
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Address 665 N MAIN ST
Agent/Owner
OSHKOSH
WI 54901 - 4431 Telephone Number 231-1750
-~
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
(t)
OfHKOfH
ON THE WATER
Plumbing
EIVED
SEP 2 4 2002
.~. ..DEPARTMEN
CjMldUNrry r't!<-T "o,[
Permit ApplffffiHiOONT
I hereby apply for a permit to do and install the followiJ?g 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 varticivating in the Permit Fee A ccount System and have adequate funds. check here
if yOU want this processed throuJlh your account n
Owner
~ "'J/J /)11 Date Q -/ '7 -fA
Value (Including labor and materialsL_<-..L/V 'VV I =-)
ntractor $/ /fE/Iy/ /~,
DMulti-Family J2ffteatal DCommercial DIndustrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
o Gas [j Elect 0 PwrVnt
-L
-L-
Lndry Standp
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrm Sink
SUTgeons Sink
Breakrm Sink
Dent. Oper. Shamp Sink
Dip Well FlrlWst Sink
DrinkFtn Catch Basin
Wait. St. Wash Ftn
Ice Chest Urinal
Exam Sink Oar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink fee Maker
Serv Sink Site Drain
Int Grease Trap Roof Drain
Ext Grease Trap Standp Rec
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Size
Material
Type
DElectric Installation Verification form attac~ed
(lfReplacement) ~
"'~
# Conn. Type \f tl ~
~ao ,00
Electric Contractor
Use I Nature ofWor
Sanitary Sewer
Storm Sewer
Water Service
3/02