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OSHKOSH
ON THE WATER
Job Address 372 S KOELLER ST
CITY OF OSHKOSH
No 0052327
PLUMBING PERMIT - APPLICATION AND RECORD
Contractor
D.R. HANSEN PLBG.
Owner LANDMARK PLAZA
Category 440 - Industrial-Interior
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
Create Date 03/04/96
Plan
Bathtub Shower
Whirlpool Floor Drain
Lavatory 1 Lndry Tray
-
Toilet 1 Lndry Stndp
Res. Sink Disposal
Bar Sink 1 Dishwasher
Water Heater 1 Sump Pump
Site Drain Classrm Sink
Roof Drain Breakrm Sink
Use/Nature
of Work
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
CONVERT TENANT SPACE TO PHARMACY
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Valuation
$2,500.00
Permit Fees
$28.00
Issued By
Date OS/20/96
U Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Address
Agent/Owner
Oshkosh WI 54901 - 0000
Telephone Number