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OSHKOSH
ON THE WATER
Job Address 1740 GEORGIA ST
CITY OF OSHKOSH No 128224
PLUMBING PERMIT - APPLICATION AND RECORD
Owner WALTER E ZEMKE Create Date 12/19/2007
Plan
Category 411 - Residential-Water Heaters
Contractor M P KELLY
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest FlrlWst Sink
Lndry Tray Clothes Wshr Exam Sink Catch Basin
Disposal Bidet Sculry 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/Grind Drink Ftn Serv Sink Soda Disp
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
SFR / REPLACE GAS WATER HEATER "check #8965
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1405870200
$25.00 D Permit Voided I
$0.00
Permit Fees
Valuation $665.00 Plan Approval
Issued By ~
Date 12/19/2007
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Date
Signature
Agent/Owner
OSHKOSH
WI 54901 - 4431 Telephone Number 231-1750
Address 665 N MAIN ST
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is, received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Inspection Services Division
POBox 1130' .
Oshkosh, WI 5490'3- 1130'
Phone: (920) 236-5050
Fax: (920) 236~5084
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. I' ON THE WATER
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Plumbing Permit Application
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JtJbAddr"!!. j7f(J 6u~
Owner 'J1LIL - .A ~u. . Contractor
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DDuplex 'OM,.ti::'Fa~ily
1 hereby apply for a permit to do and install the follow1ng plumbfug on thepretrtises hereinafter described, the work tooonf;Otrn;;to the
Wisconsin State Plumbing Code, in the performance of which aU parties hereto: agree tq and are bound by said statllte.s. .
. Application(s) and fee(s) can be broughftQ CitylIall.Roorrt.Z05()rmaileqt6JnspecuonServices. PO BoxH28,
Oshkosh WI 54903-1128. Commencing wotkwithotitpennit(s) WjlLte$ult:in fees bei~gdoub:le~lQr $100.00 plu~the
normal permitfee. which ever is greater; . .
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Ifvouare a contractor particivating intH~PermitPeeAcc(mn.tSvsiemaf1.'dhdveddequatefu1fds. check here
ifvou want this processed throughvo,ur accountn .... . . :. .'
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Electric Contractor . . . .' cOli. '.:EJElecttl~~InstajI~ti~n:Verificttt~ij::foJ;m attached
use/Natureofwork.I............ /L:.,.... d.' /l . a tl-(!/Q.... ... ...M~ . ..' ..... ..
.t4~ V6".... .... ".
Size Material TyPe. .'"
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Water eater L
.0 Elect 0 PwrVnt
Shower
Fioor Drain
Lndty Tray,
Lab Sink
Plaster Sink'
Sterilizer
Misc.
'\
-"::-
Fixtures
Sanitary Sewer
/Stbrm.Sewer..'
WaterService
Uate '0Lf/t ;/'
.' ". t' . "f
; Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Locat'Waste
Clothes Wshr
Bidet
Beer Tap
ClassnnSin'k
.StJrgeonsSink
Breakrm !;link
Dip Well
DrinkFtn
Wait.St
.. . Ice Chest
;Exam Sink
Catch Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Ice Maker
Site Dra[j1
~QOf.Draln .
Stiin4p Rec .
.,EyeW$b'Stn
Wtr Sewer.Mtrs
DetlUcrMeters
Witr'l)sageMtrs
...,...;..-
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.--....0..--
$$;~ll:Y Sink
H~!i~1S!~~, ".
F PrepSltik
.SetvSink
....Jnt,gr~a~etrap
';'E"liQ~ase:Trap ,
. RiPi,Z.' Valve .
S,hamp"'Si.rtk
../Elr!ylstSi~k.
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