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HomeMy WebLinkAbout0098149-Plumbing (ACW) o OSHKOSH ON THE WATER Job Address 514 HIGH AVE CITY OF OSHKOSH No 98149 PLUMBING PERMIT - APPLICATION AND RECORD Owner JOHN T/L1NDA A PORIOR Create Date 10/25/2002 Contractor ADAMS PLUMBING Category 410 - Residential-Interior Plan Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0 - Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0 Lavatory 0 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0 - Toilet 0 Lndry Stndp 1 Clothes Wshr 0 Ice Chest 0 FlrlWst Sink 0 Int Grease Trap 0 - Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0 - Bar Sink 0 Dishwasher 0 Beer Tap 0 Sculry Sink 0 Wash Ftn 0 - Water Heater 0 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 Use/Nature RENT AU DUPLEX! Auto clothes washer. .. of Work Size Material Type # Conn. Type Sanitary Sewer o o o o o Storm Sewer o o o o o Water Service o o o o o Valuation $450.00 Plan Approval $0.00 Permit Fees $20.00 Issued By J.<.('t) Date 10/25/2002 D Permit Voided I In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction. Signature Date Address 1570 N OAKWOOD Agent/Owner OSHKOSH WI 54904 - 0000 Telephone Number 233-2661 " City of Oshkosh inspection Services Division POBox 1130 Oshkosh, WI 54903-1130 Phone: (920) 236-5050 Fax: (920) 236-5084 ~ OfHKOfH ON THE WATER Plumbing Permit Application 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 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 vou are a contractor participating in the Permit Fee Account Svstem and have adequate funds. check here if vou want this processed through vour account n Job Address -5 ) '-I U 1(7 r( ST ~~ ~OQ,.lO~ ~Duplex Owner E]Single Family Number of Fixtures: Bathtub Whirlpool Lavatory Toilet Res. Sink Bar Sink Water Heater C Gas [J Elect C PwrVnt Shower Floor Drain Lndry Tray Lab Sink Plaster Sink Sterilizer Lndry Standp Disposal Dishwasher Sump Pump Ejector/Grind Water Softner Local Waste Clothes Wshr Bidet Beer Tap Classrm Sink Surgeons Sink Breakrm Sink Electric Contractor Value (Including labor and materials) J:;srJ .C() ADAMs VJ l()4 ~Rental DCommercial Contractor DMulti- Family 1- Date /0 .J It .O~ Dlndustrial Dent. Oper. Shamp Sink Dip Wen FlrlWst Sink DrinkFtn Catch Basin Wait.St. Wash Ftn Ice Chest Urinal Exam Sink Gar Drain Scu]ry Sink Soda Disp Hand Sink Coffee Maker F Prep Sink Ice Maker Serv Sink Site Drain Int Grease Trap Roof Drain Ext Grease Trap Standp Rec OR DElectric Installation Verification form attached (If Replacement) Use / Nature of Work ~L'> to CltJ~~s LtA6S~ Size Material # Conn. Type Sanitary Sewer Storm Sewer Water Service Type 3/02