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OSHKOSH
ON THE WATER
Job Address 1550 GALWAY CT
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
No 127520
Contractor KOCH PLUMBING
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner JEFFREY A/DEBRA J TEETZEN
Category 411 - Residential-Water Heaters Plan
~-----_.._-_.._-~---~--------------
Create Date 10/26/2007
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Lab Sink
Sterilizer
DipWelJ
Drink Ftn
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
UselNature SFR / Replace gas water heater. "DEBIT ACCt...
of Work
Valuation
Issued By
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
-~----'---'---'--.-l
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
Conn. Type
Parcelld #
1320515100
$600.00 Plan Approval
~-()~
___ $0.00
Permit Fees
#
$25.00 D Permit Voided J
Date 10/26/2007
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature
Address 2005 DOTY ST
Agent/Owner
OSHKOSH
Date
WI 54902 - 7040 Telephone Number 920-231-6661 or 235
To schedule inspections please call the Inspection Request line at 236-5128 noting the Adclress, Permit' Number, TYpe of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
Oct 26 07 11:1Sa
Clarence Koch
(920) 235-0282
10.2
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Ph()ne: (920) 236-5050
Fax: (920) 236-5084
~
OJHKOfH
ON TH ~ WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter descnoed, the work to conform to the
Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pennit(s) will result in fees being doubled or$l 00.00 plus the
normal permit fee, which ever is greater.
OR
If YOU are a contractor varticioating in the Permit Fee Account System and have adequate funds. check here
ifvou want this processed through your account J2g
Job Address/S-SO a/l~IP"/fo/ eT Value (Including labor and materials)
Owner kr-~ 7:ecTZf~./
IRfSingle Family DDuplex DMulti-Family
Contractor
ICOC/Y
DRental
600 J~'~"
r-:i8 ~
DCoinmercial
Date It':?-Z? -0;
DIndustrial
".
J,
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater .......l-..
R:.Gas 0 Eject 0 PwrVnt
ShDwer
Floor Drain
l.ndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
Fixtures
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Local Wasle
Clothes Wshr
Bidet
Beer Tap
Classnn Sink
Surgeons Sink
Breaknn Sink
Dip Well
Hose Bibs
DrinkFb:t
Wait. St.
Ice Chest
Exam Sink
Scull}' Sink
Hand Sink
F Prep Sink
Serv Sink
Int Grease Trap
Ext Gre2se Trap
R.P.Z. Valve
Shamp Sink
FlrlWst Sink
Catx:h Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Comm. Ice Maker
Site Drain
Roof Drain
Standp ReI;
Eye Wash Stn
Wtr Sewer MlrS
Deduct Meters
Wtr Usage MlrS
Electric Contractor
OR , DElectric Installation Verification form attached
(If Replacement)
Use I Nature of Work
~// ~-'?'C./z..~ U/Jtt Ti(~/l
I...I...('~~" -r ,:~-:;;"".....
I , .'... ,..... ,- '-.., " f.. ,
Size
Material
Type
#
Conn. Type
~Q
(\0
,~
\
Sanitary Sewer
Storm Sewer
Water Service
MX /O-z:c:; -07
11/05