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OSHKOSH
ON THE WATER
Job Address 2291 PATRIOT LN
Contractor D & S MECHANICAUAZMS LLC
CITY OF OSHKOSH
PLUMBING PERMIT . APPLICATION AND RECORD
No 124531
Category 410 - Residential-Interior
Owner ROBERT B/JOYCE J FICK REV TRUST
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Shower
Floor Drain
1 Lndry Tray
1 Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Create Date 04/30/2007
Plan
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Lab Sink
Sterilizer
Dip Well
Drink Ftn
Wait. St.
Ice Chest
Exam Sink
Sculry Sink
Hand Sink
Plaster Sink
Surgeons Sink
F Prep Sink
Serv Sink
Shamp Sink
FlrlWst Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Finish bathroom in basement.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1621641401
Valuation
Issued By
$2,300.00 Plan Approval
~
$0.00
Permit Fees
$25.00 D Permit Voided I
Date 05/01/2007
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 permi a Iication within C' trongly urges the permit applicant to contact the
easement holder(s) essary a fore starting such activity.
Signature
Address
OMRO
Date
WI 54963 - 0000 Telephone Number 920-685-5263
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.
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
~
OJHKOfH
ON THE WATER
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 mspection 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 vou are a contractor participatinfl in the Permit Fee Account Svstem and have adequate funds. check here
ifvou want this processed throuflh your account n
o . I" .. J1 ~ r! I r
Job Address ~ "t I I 4 + ~ 0,- LN.V alueCm,J"';", J,b~""" =,,",J,) .J }0lI Date ~
Owner t "'8 F'L\<' Contractor b t.5 ('vi 6 G.H~' ul
. ~Single Family Dnuplex DMulti-Family DRental DCommercial DIndustrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
o Gas 0 Elect 0 PwrVnt
-}-
\
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrm Sink
DrinkFtn Catch Basin
Wait. St. Wash Ftn
Ice Chest Urinal
Exam Sink Gar Drain
Scu]ry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink Comm. Ice Maker
Serv Sink Site Drain
Int Grease Trap Roof Drain
Ext Grease Trap Standp Rec
R.P.Z. Valve Eye Wash Stn
Shamp Sink Wtr Sewer Mtrs
Flr/Wst Sink Deduct Meters
Wtr Usage Mtrs
Shower ---.J5.-
Floor Drain
Lndry Tray
Lab Sink
Surgeons Sink
Breakrm Sink
Dip Well
Hose Bibs
Plaster Sink
Sterilizer
Misc.
Fixtures
I tJS 7tLt...
OR
b' ,A-'" AI
DElectric Installation Verification form attached
(lfReplacement)
Electric Contractor
Use / Nature of Work
t N .L~.'td ffA 1).iAi~jV Y
Size
Material
Type
#
Conn. Type
?Jt
40
11
Sanitary Sewer
Storm Sewer
Water Service
11/05