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OSHKOSH
ON THE WATER
Job Address 220 W SMITH AVE
Contractor AHERN-GROSS INC.
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner NORMAN F/JENNY D BURMEISTER
No
127763
Carego~ 410-Res~~ntial-lnterior_
Create Date 11/12/2007
Plan
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Bathtub
Whirlpool
Lavato~
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature ~FR / Replace standard bath/shower faucet witli-piessure balance faucer-------------~--.---.-..------.---
of Work
Valuation
Issued By
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest FlrlWst Sink
Lnd~ Tray Clothes Wshr Exam Sink Catch Basin
Disposal Bidet Scul~ 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/G rind Drink Ftn Serv Sink Soda Disp
I
l._____
Size
Material
Type
#
Conn. Type
!
- -______1
Sanita~ Sewer
Storm Sewer
Water Service
$400.00 Plan Approval
-_._-~
_..____~.oQQ
_ _.____J..?~:.Q2 O_.F'~rrl1~t _\f9i~edJ
Parcelld #
1518440000
Permit Fees
Date 11/12/2007
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
Agent/Owner
FOND DU LAC
Date
WI 54935 - 4908
Telephone Number 920-921-1414
Address 218 S MAIN ST
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.
'City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
~
OfHKOfH
ON THF WATFR
Plumbing Permit Al!)llication
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 performance of which all parties hereto agree to and arc bound by said statutes.
Job Address
Owner
220 w. Smith AVe. $ 400 00
Valuc (lncludinglahllrandmalnials) .
Datc 10-19-2007
Jenny Burmeister
Contractor
Ahern-Gross Plumbing
~Single Family
DDuplex
DMulti- Family
DRental
DCommercial
Dlndustrial
Number of Fixtures:
Bathtub' Fau::et
WhirlpO<iC',..
Lavatory
Toilet
Res. Sink
Bar Sink
Water Healer
o Gas 0 Electric II Power Vent
_-.-L_
Sterilizer
Ilrcakrlll Sink
I.ndrySI;lndp
Disposal
Dishwasher
Sump Pump
Ejector/Grind
WalerSoftncr
Local Wasle
Clothes Wshr
Bidet
Bcer Tap
Classnn Sink
Surgeons Sink
, ,,>..Denl. Opa.
>\!"~' ,,;!~ u...
Dip Well
Drink Ftn
Wait.St.
Ice ChC~1
Exam Sink
L~~,~"', .;. ~',.'i ~
Slla;;lp Sit;~;'\';
j:i;;~JrUi~lk
Calch Basin
Wash FIll
Urinal
Gar Drain
F Prep Sink
Scrv Sink
Soda Disp
Cllffc~ Maker
Ice Maker
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sculry Sink
lIand Sink
Int (Jrease Trap
Exl Grease Trap
Site Drain
Rnof Drain
Slandp Ree
Electric Contractor
OR
o EIV form attached (If Replacement)
Use / Nature of Work
Replace stardard b3.th/sh:w::r fau::et with pressure b3.larce fau::et.
Water Service
'iw~ecewEe..
NOV 1 2 2007
DEPARTMENT Of
''',--. .., '''' '--'---~-~-'-I-NCsOpEM;t~~Y;E~~~~=iON-
1" ,~ <.' . f
'. .. " .;)','-' f:!,~"-'i " _'''\~'.,~-,,:~j '_'>~r - ',"".-".
."., Application(s) and fee(s) can be brought to City Hall, Room 205. prmailed to Inspection Services, POBo~'l128, Oshkosh WI
54903-1128. Commencing work without pcrmit(s) will result in fees being doubled or $100.00 plus the nobnal permit fee,
which ever is greater.
OR
Size
Material
Sanitary Sewer
$ 25.00
Stotnl Sewer
" 'i').;. ~\
.,. ~.; H"
Check here i f~_t:':.,:,n ~__p:j~r~,E.!!J?ed throu2E-yol1!-~~coun.!: 0