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OSHKOSH
ON THE WATER
Job Address 1118 E NEVADA AVE
PLUMBING PERMIT. APPLICATION AND RECORD
CITY OF OSHKOSH No 128220
Owner MARY C MASON Create Date 12/19/2007
Plan
Contractor M P KELLY
Category 411 - Residential-Water Heaters
Bathtub Shower Water Softner Wait. St. Shamp Sink
Whirlpool Floor Drain Local Waste Ice Chest FlrlWst Sink
Lavatory Lndry Tray Clothes Wshr Exam Sink Catch Basin
Toilet Disposal Bidet Sculry Sink Wash Ftn
Res. Sink Dishwasher Beer Tap Hand Sink Urinal
Bar Sink Sump Pump Lab Sink Plaster Sink Standp Rec
Water Heater Classrm Sink Sterilizer Surgeons Sink Ice Maker
Site Drain Breakrm Sink Dip Well F Prep Sink Gar Drain
Roof Drain Ejector/Grind Drink Ftn Serv Sink Soda Disp
Misc.
Fixtures
Use/Nature SFR / REPLACE GAS WATER HEATER "check #8965
of Work
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Size
Conn. Type
Material
Type
#
Sanitary Sewer
Storm Sewer
Water Service
Valuation $698.00
Issued By ~
$0.00
$25.00 D Permit Voided I
Plan Approval
Permit Fees
Parcel Id #
1511370000
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
AgenUOwner
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 Services Division
POBox 1130
Oshkosh, WI 54903- 1130
Phone: (920) 236-SOS0
Fax: (~20) 23~5084
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Q7RKOfH
. \' ON THE WATER
PlumbingPertnifAppUcation
Ihereby apply for a pennit to do .and install the follow-ingplumbirtg on the.prenrises hereinafter described, the work tocont~tn;hto the
Wisconsin State Plumbing Code, in the performance of which aU parties hereto: agree tq and are bound by said stanlte.s. .
· Application(s) and fee(s) can be broughlto City'ilal1,.Ro(jm2;()5:()rmai1~dt6Ii1spectionS~ces, PO Box 1128,
Oshkosh WI 54903-1128. Commencing: work Withoutpennit(s)WilLre~uJt.fu fees beingdouQle9or $1 00.00 plu~the
normal permitfee, which ever is greater; . .
OR
Iou.are a contractor artici ati1iin'tkePermlt
ou want this rocessed throu hO.il. account.
J<>IiAddr~ II/Y[:,dl..tUt<-
OWne /J1~ /Ujlcfi1-r\ . Contractor
ingle Family Duplex.' 'OM~{ti::'Fa~y
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,/.../'
check here
1/ I. '4...
,;Ilate /~~....}
: [Jlndust,)'i<<.
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink --j-
Water tyt~'-L-
~nElect 0 PwrVnt
Shower
Floor Drain
. Lndiy Tray,
Lab Sink
; Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softnet
Loca!"Waste
Clothes Wshr
Bidet
Beer Tap
ClassnnSink
SilrgetJns.5ink
Breakrm'Sirtk
Dip Well
DrinkFtn
Wait. St.
Ice Chest
;Exam Sink
.::~~;;;;.
F PreP'Sink
ServSlnk
,'Jn~,q)'~~e Trap
.';:Ex~:Q~e:l'taP
.RiP iZ;:V at:v.e
,Shamp"S!rtk
'. fF.Irf.Ws(Sll1~
~
Catch Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Ice Maker
Site Drain
RQQt-Drain .
'Stiilldj'; Rec;
. Eye. Wash'Stn
Wtr Sewer'Mtrs
Deduc;tMeters
Wh'IJsageMtrs
~
~~
.~
, --'--
~
.~
'----
--------
~.
Plaster Sink'
Sterilizer
Misc.
Fixtures
"
~
~',
-=----.:....
Electric Contractor
. Use I Nature of Work ,A1!JtJfj
..
,0El~ctFi:~iJnstaJi~tion:Verifjc~ti~ti\'(oJ;m att~ched
(It:Rei>la(;~n:ienl)' . '. . .... '.
, tJl!....
Nlf
Size
.Material
#.
Type
:,:.CQ~.:T~e,; .
rp~
Sanitary Sewer
'8tormSewer
'. . .~.
Water$ervice
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