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OSHKOSH
ON THE WATER
Job Address 2021 MOUNT VERNON ST
CITY OF OSHKOSH
No
122338
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
2 Hose Bibs
Owner PATRICIA A NOURSE Create Date 10/19/2006
Category 410 - Residential-I nterior Plan
Water Softner Wait. St. Shamp Sink Coffee Maker
Local Waste Ice Chest FlrlWst Sink Int Grease Trap
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
Contractor O'NEILL ENTERPRISES INC
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
2
1
3
3
1
NSFD/ New single family' with 2 car attached garage, 12' x 12' patio, 20' wide driveway.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1515390000
$5,500.00 Plan Approval
~
$0.00
$126.00 D Permit Voided I
Permit Fees
Date 10/30/2006
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
Address 522 W 6TH AVE
OSHKOSH
WI 54902 - 0000 Telephone Number 920-230-2007
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.
10/30/2006 15:55 FAX 8202302008
0' NEILL
141 004/004
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
Plumb.ing 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 perfonnance of which aU 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 \\'1 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
nonnal permit fee, which ever is greater.
OR
Job Addressda0! Jif. Vf/LtlbfLj
Owner '0 ""- 'H<:..~.....r(\.......
;riSingle Family DDuplex
Number of Fixtures:
Balhrub 1
Whirlpool
Lavatory
Toile~
Res. Sink
Bar Sink
--L.
:3
f
Wat~r Hellter ~
1M' Gas 0 Elect 0 PwrVnt
Shower -L
Floor Drain [
Lndry Tray
Lab Sink
Pla&ter Sink
Sterilizer
Misc,
Fixlures
Electric Contractor
Use I Nature ofWark
re
4t c:.
Value (lncludin~ labor and materials)
Contractor 0 I I .
DMulti-Family
DRental
DIndustrial
DispoSllI I Drmk Fin Catch Basin
Dishwasher \ Wait.S! Wash rrn
Sump Pump 14;e Chest Urinal
Ejer;torfOrind Exam Sink Gar DraIn
W~tc:r Sollner Scull)' Sin\( Soda Disp
Local Waste Hand Sink Coff~ Maker
ClOthes Wshr F Prep Sink Comm. lee Maker
Bidet Scrv Sink Site Drain
Beer T~p Int Grease Trap Roof Dr;;lin
Classrm Sink E)..1 Grease Trl>p $lancp !tee -L-
Surgeon!! Sink ltP.Z. Val~e Eye WElSn 8m
Brcnkrm Sink Shamp Sink Wrr Sewer Mlr:;
Dip Well Plr/Wst Sink DedUCt MeterS
Hose aibs z. Wtr Usage Mus
OR
DElectric Installation Verification form attached
(IfRel'lacamcnt)
Size
Material
Type
#
Conn. Type
roq
\~\1yb~ ~
\jJ ~/f)
\0--
Sanitary Sewer
Storm Sewer
Water Service
11/05