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OSHKOSH
ON THE WATER
Job Address 1840 EVANS ST
Contractor M P KELLY
CITY OF OSHKOSH No 128227
PLUMBING PERMIT - APPLICATION AND RECORD
Owner DR MITCHELL R TULIP Create Date 12/19/2007
Plan
Category 441 - Industrial-Water Heaters
Shower Water Softner Wait. St.
Floor Drain Local Waste Ice Chest
Lndry Tray Clothes Wshr Exam Sink
Disposal Bidet Sculry Sink
Dishwasher Beer Tap Hand Sink
Sump Pump Lab Sink Plaster Sink
Classrm Sink Sterilizer Surgeons Sink
Breakrm Sink Dip Well F Prep Sink
Ejector/Grind Drink Ftn Serv Sink
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature COMM / REPLACE GAS WATER HEATER .'check #8965
of Work
Shamp Sink
Flr/Wst Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Size
Material
Sanitary Sewer
Storm Sewer
Water Service
Type
#
Conn. Type
$0.00
Permit Fees
Parcel Id #
1519400200
Valuation $688.62 Plan Approval
Issued By ~
$25.00 D Permit Voided I
Date 12/19/2007
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
Address 665 N MAIN ST
Agent/Owner
OSHKOSH
WI 54901 - 4431 Telephone Number 231-1750
Date
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 Se:rvi~es Division
POBox 1130 ,
Oshkosh, WI 54903-1130
Phone: (920) 236~5050
Fax: (920) 236~5084
Plumbing ,Permit ,Application
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CTfHKOJH
. " ON THE WATE!?
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Ihereby apply for a permit to do .andinstall the following plum~irtg on theprelilises hereinafter descn'bed, the work tocaIjl;lp:n:,to the
Wisconsin State Plumbing Code, in tbeperfonnanceQfwhichaUpartieshereto:agr.ee tq and are bound by said statutes. .
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'. Application(s) and fee(s) can be broughtto CityJiall,:Room~Q5Qrn;miledt6Inspet:tion:S~ces, PO Box llis,
Oshkosh WI 54903-1128. Commencing woikwithoutpertrlit(s}:Will~ri:tt:ii1 fees being;dotil?le~pQr $100.00 plu!lth.e
normal pennitfee, which ever is greater. .
OR . ' " ..~
If vouare a contractor participatinftih41i~'Per.m..it.F~eAcc(J:1illJSvsiema.ndhav.eddequatefulIds. check here
~f~ou want this processed throughVQ,uraccountn.' , " . " .:. ,
Job Addre$S_\ ~ -+0 e"ANS,:', .... VaIUe(IncI:djriglabQr~d:n1a~ai~r
OWner --:D~ .~\~~cont~actor . .'. 'i>>~':
DSingle Family DDuplex. 'OM~~lti;;'FaQ:!ily
J. :r
J)a~W
. . ...
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
. Watepfleater \
p6asoElect 0 PwrVnt
Shower
Floor Drain
Lndty Tray.
Lab Sink
Plaster Sink'
Sterilizer
: Di~posaJ
Dishwasher
Sump Pump
Ejector/Grind .
Water Softner
Local'Waste
Clothes Wshr
Bidet
Beer Tap
ClassnnSink
SUrge"OnsSink
BreakTTn' $ilik
Dip Well
\~
DrinkFtn
Wait.St.
.' ...; _..;
'-
"",. . Ice Chest
~
<!"
~
;Exam Sink
$~~4;YSink
..m~~!r~;'
F Prq)''Slrik
,Serv.Sink
'In.tI;q~s.eT.rai>', .
. .. .~
,'I3'<itl(f~s((rap
. '.R;PiZo'Vaive
Shiunl";Sink
41IrJyls(Sln~ .
---..,.
.~
.~
" .
~
~.
',.
"-
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Misc.
Fixtures
Catch Basin
WashFtn
Urinal
Gar Drain
Soda D.isp
Coffee Maker
Ice Maker
Site Drain
. Roo.fDraiu .
.' .Stilt:ld~: Re<;
EyeW~'Sh'S.tn
WtrSewer.Mtrs
.DeductMeters
Witr'JjIsageMtrs
:!i
Electric Contractor
. U.e I Nature of Work , ~~Hff
Size ,Material
"
.OR I3Electr,i~.lnstl\liation Verifi:cati~n:-ro~m attached
kC}tt~/(It""'1>.....t). .
Type.>. '#<
Sanitary Sewer
':StormSewer...
',"
Water$e.rvice
.,' ~t~
.~
4105