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OSHKOSH
ON THE WATER
JobAddress 1110W19THAVE
Contractor HANSON QUALITY PLUMBING
Bathtub
Whirlpool
Lavatory
Toilet
Res, Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
CITY OF OSHKOSH
No 124613
PLUMBING PERMIT - APPLICATION AND RECORD
Owner MARK EITHERESA BOETTCHER
Create Date 05/02/2007
Category 410 - Residential-Interior
Plan
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest Flr/Wst Sink
1 Lndry Tray Clothes Wshr Exam Sink Catch Basin
-
1 Disposal Bidet Sculry Sink Wash Ftn
Dishwasher Beer Tap Hand Sink Urinal
Sump Pump Lab Sink Plaster Sink Standp Rec
Classrm Sink Sterilizer Surgeons Sink Ice Maker
( Breakrm Sink Dip Well F Prep Sink Gar Drain
Ejector/Grind Drink Ftn Serv Sink Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
SFR/ Finishing a portion of the basement' to include a family room and a full bathroom '*debt acct
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1311610000
$0.00 Permit Fees
$25.00 D Permit Voided I
Valuation $3,500.00 Plan Approval
Issued By ~ (I\)
Date 05/03/2007
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
Agent/Owner
APPLETON
WI 54914 - 0000 Telephone Number 730-0205
Address 550 N BLUEMOUND RD
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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.
~.
HANSONS QUALITY PLUM
PAGE 01/01
05/03/2007 12:26 920
Ci.ty ofOsbkosb
Inspection Services Division
POBox 1130
Osl1lcosh, WIS4903-1130
Phone: (920) 236-5050
Fax: (920) 236.5084
. . . ~.,"
~
OfHKOfH
~ ON rt-I!; WATER
Plumbing Permit Application
I bereby apply for a pennit to do and install the following plumbing on the premises hereinafter described, tl)e work to conform to the
Wisconsin. State Plumbing Code, in the per{oWlance ofwbich all parties hereto agree to and are bound by said statutes.
· Application(s) aud fee(s:) can be brought to City Hall, Room 205 or mailed to Inspection Services. PO Box 1128>
Oshkosh WI 54903-1128. Com.m.enciflg work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fec, which ever is greater.
OR
Ifvou are a contractor artici atfn in the Pe.,. e Account Svsrem and have adequate runds~ check here
ifvou want this rocersed th.,.ou h ou.,. aCCOunt
Job Address~//d tv /9# ~
(f~
...-r;
Ow:o.er f.t/IA'~~
~ngle Fa~iJY
Number of Fixtures:
-L
-L
-L.
Bathtub
Wl.1irlpool
uwtory
Toilet
Res. Sink
BaT Sink
Water Heater
o Gas 0 Elect D PwrVnt
Shower
Floor Drain
Lndry Ttay
!.lib Sink
Plaster Sink
Stcrilize.r
Mise.
Fix;tlJres
Electric Contractor
, Use / NatuJ"e of Work
Sanitary ScweT
Storm Sewer
Water Service
Value (lncludinglaborllndmatcrillls) JSuv- uv DateS/; h 7
S~ 1/"/7..( Co"'o 1r!A...~..I-uJ;...--
v
DRental DCommerciaJ DIndustrial
DDuplex
Contractor
OMulti-FamiIy
Dil>p osnl
Dishwa~hcr
Sum~ Pump
Eje<:tor/Grind
Water So:(1:net
Local Waste
DrinkFtn Catch B~sin
Wait. St. Wasl1l"m
Ice Ch<:..qt Urinal
E.xam Sink GlIr Drain
SC1~lry Sink Soda Di~p
I-I~nd Sink Coffee Maker
F !'rcp Sink Comm. fcc Maker
Serv Sink Site Omin
In! Grease Trap Roof Drain
Ext GroMe Trap Standp Rae
RP.Z. Valve Eye Wash Sin
Shamp Sink \Vtc Sewer Mll"~
Flr/Wst Sink Deduct Mctcrs
Wtr 1Js~.ge Mtrs
Clothes W~hr
Bidet
Beer Tap
Classrm Sink
SUI'Beons Sink
Elreakrm Sink
Dip Well
Bose Bibs
OR
DElectdc Installation Verification form attached
(If Replace1nent)
Size
MatmiaI
TyPe
#
Conn. Type
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