HomeMy WebLinkAbout0125566-Plumbing (fixtures)
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OSHKOSH
ON THE WATER
Job Address 5 E CUSTER AVE
CITY OF OSHKOSH
No
125566
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
EjectorlGrind
Owner VICTOR A SERWE JR Create Date 0612812007
Category 410 - Residential-Interior 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 LARRY HANSEN PLBG
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
UselNature [Duplex 1 lower unit.
of Work
Valuation
Issued By
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1504980000
$800.00 Plan Approval
~
$0.00 Permit Fees
$25.00 D Permit Voided I
Date 06/28/2007
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
GREENVILLE
Address N-1044 TOWER VIEW DR
WI 54942 - 8683 Telephone Number 920-757-6863
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.
May. 14. 2J0712:J6PM
City of Oshkosh
Inspection. Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-50S0
Fax: (920)236-5084
inspection s~rvices
~.~00
ih2E07 P. i
~
DJHRQ(H
ON r~E Vv'AT~
Plumbing Permit Application
1 hereby apply for a permit to do and install the following plumbing ou the premises hereinafter described, the work to conform to the
Wisconsin State Pl'U1:!lbing Code, in the perfon:rumce of which all parties hereto agree to and are bound by .said statutes.
· Application(s) and feces) can be brought to City Han, Room 205 Qt mailed to Inspection Ser:vices, PO Box 1128.
Oshkosh WI 54903-1128. Commencing work wit.rlOUt permjt(s) win result in fees being doubled or $100.00 plus the
no:r:tnal pennjt fee. which ever is greater.
OR
Ifvoll. ~re a contractor "articipaliflg in the Permit Fee AccoLlnt System and have adequate funds. check here
ifvou ~ltr. this processedthrourzh your aCCount 0
Job Address 5 .f:. UJ~~.
$Qc..\.l'L
WDuplex
ClpfO)( - -r~1V}
ValueCIncludinglal:>orai'lGlnatlltials) f!>>oo Date c,-2...tc -0,
Contractor Wf\.{ t\.Q?l(\~
~ental DCommercial Dlndustrial
Owner
DSingle Family
Number of Fixtures:
n B~th~7~:" --1....:"
Whirlpool
t..:.avacoiy'" '
Toilet
'~'kbs. 'S.i.nk 'A/C?
flar Sink
Water H~!IIi:T
o Ga~ 0 Ele~t u PwrVnt
+
ShOW~r
Floor Dr..!n
. L.'1.diy Tray
Lab Sink
Plasu,rSink
Steri lizeT
Mioc..
Pix:t.m:s
Electric Contractor
l:s~ lNature of Work
r- ..
Sanitary Sewer
StotLti:Sewer
! Wat~r Sv"rVlce
DMulti-Family
~~
Disponl
Dishwa:iher
Sump Pump
EjeetorfGrind
Watlrr SOfb1er
Loca'fWso;ie .
Clothes Wshr
Bidet
Seer Tap
Clas.um Sink;
SurseoJ\s Sink
Brcal<rm Sir.k
nip Well
Hose Bfb:!
Drink .Fin
Wait.St
ree C'hett
2J<a1T\ Sink'
Sed!')' Sink
H.B.l1C Sink
" Prep Sink
Sorv Sin\:
mt Grease Trap
Ext GriroSe Trap
R.P,Z. Valve
SllaIllp Sink
FlrIWst Sink
Clltch Basin
Wash Flll
Urilla1
Gll/' Drilill
Soda Disp
Cofft:t:Maker
Cumm. Ice Maker
Siftl Drain
Roof Drain
Standp R,ec
Eye Wash Stn
Wlr 5cw~r Ml.l's
Oeduct Meters
WIT Usage Mils
OR
DElectric Installation Verification form attached
(IfReplllCll!'rJ.!mi)
Conn. type !
Size
Material
Type
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