HomeMy WebLinkAbout0099881-Plumbing (water heater)OSHKOSH
ON THE WATER
.lob Address 258 W 14TH AVE
Contractor LARRY HANSEN PLBG
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JAMES F/PATRICI KUBASTA
Category 411 - Residential-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 Lndry Stndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 99881
Create Date 02/20/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature RENTAL/Replace gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$300.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date
02/20/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address N-1044TOWER VIEW DR GREENVILLE WI 54942 - 8683 Telephone Number
(C)851-6863
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax:'(920) 236-5084
Plumbing Permit App
O,./'HKO/H
ON THE W,A, TER
I hereby apply for a permit to do and install the following plumbing on thc 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 Inspection 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 Fou are a contractor participating in the Permit Fee Account SFstem and have adequate funds, check here
(f Fou want thisprocessed through Four account ['-]
Job. Address ~'~5~ {..JO. I L'~
Owner"' ~Dl~ ~D~}[c~LGo
[--]Single Family [--IDuplex
~..P,~ Value (Including labor and materials)~)~)
Contractor
~Multi-Family ~enta, ~lndustrial
Number of Fixtures:
Bathtub Lndry Standp
Whirlpool Disposal
Lavatory Dishwasher
Toilet Sump Pump
Res. Sink Ejector/Grind
Bar Sin..k Water Softner
Wat'e~ Heater ~ Local Waste
Gas [] Eleci [3 PwrVnt Clothes Wshr
shbWer' Bidet'
Floor Drain _ Beer Tap
Lndry Tray Classrm Sink
Lab Sink Surgeons Sink
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Sanitary Sewer
Size
Material
Dent. Oper. Shamp Sink
Dip Well FIr/Wst Sink
Drink Ftn Catch Basin
Wait. St. Wash Fm
Ice Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink Ice Maker
Serf Sink ' Site Drain
Int Grease Trap Roof Drain
Ext Grease Trap Standp Rec
O-R ["-IElectric Installation Verificati{~n form attached
(If Replacement)
Type # Conn. Type
Water Service
3/02