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OSHKOSH
ON THE WATER
Job Address 1213 HARNEY AVE
CITY OF OSHKOSH No 86198
PLUMBING PERMIT - APPLICATION AND RECORD
Owner LESLIE K JACOBSON Create Date 05/07/2001
Contractor SAMMONS PLUMBING
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Shower
Floor Drain
Lndry Tray
Lndry Stndp
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Category 411 - Residential-Water Heaters Plan
Ejector/Grind Dip Well F Prep Sink
Water Softner Drink Ftn Serv Sink
Local Waste Wait. St. Shamp Sink
Clothes Wshr Ice Chest FlrlWst Sink
Bidet Exam Sink Catch Basin
Beer Tap Sculry Sink Wash Ftn
Dent. Oper. Hand Sink Urinal
Lab Sink Plaster Sink Standp Rec
Sterilizer Surgeons Sink Ice Maker
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap _
Use/Nature Install water heater
of Work
Valuation
Issued By .~
;
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
#
Conn. Type
$450.00
Address 522 W. MURDOCK AVE
Plan Approval
$0.00
Permit Fees
$20.00
Date OS/22/2001
D Permit Voided I
Signature
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
Date
AgenUOwner
OSHKOSH
WI 54901 - 0000
Telephone Number 414-231-9880