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OSHKOSH
ON THE WATER
Job Address 1930 aMRa RD
CITY OF OSHKOSH
No
123934
PLUMBING PERMIT - APPLICATION AND RECORD
Contractor J RASMUSSEN PLUMBING INC
Shower
Owner 1930 aMRa RD LLC reate Date 03/26/2007
Category 440 - Industrial-Interior Ian
Water Softner Wait. St. Shamp Sink Coffee Maker
Local Waste Ice Chest FlrlWst Sink Int Grease Trap
Clothes Wshr 1 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
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature Install clothes washer hook ups in kitchen area.
of Work
Valuation
Issued By
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1610970000
$200.00 Plan Approval
$0.00 Permit Fees
$25.00 0 Permit Voided
Date 03/26/2007
In the performance of this work, I agree to perform all work pursuant to rules goveming 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 w rk
described in this permit applicati ithin an easement, the City strongly urges the permit applicant to contact the
easement holder(s) d to se r ny necessary approvals before starting such activity.
Signature Date J - ~ tv .... 0 7
Agent/Owner
Address 1914 GREENBRIAR TRL
OSHKOSH
WI 54904 - 0000 Telephone Number 920-233-6747
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Per it Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), y ur Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is re ived. Work may
continue if the inspection is not performed within two business days from the time the project is rea y.