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OSHKOSH
ON THE WATER
Job Address 1404 TAFT AVE
Contractor M P KELLY
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
CITY OF OSHKOSH
No
128226
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JEROME/DELORIS A GRUNWALD LIFE ESTAT Create Date 12/19/2007
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Category 410 - Residential-Interior Plan
Water Softner Wait. St. Shamp Sink Coffee Maker
Local Waste Ice Chest FlrlWst Sink Int Grease Trap
Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
Bidet Sculry Sink Wash Ftn RPZ Valve
Beer Tap Hand Sink Urinal Eye Wash Statn
Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Sterilizer Surgeons Sink Ice Maker Deduct Meters
Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Drink Ftn Serv Sink Soda Disp
SFR / REPLACE TOILET **check #8965
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1604200000
$0.00
$25.00 D Permit Voided I
Valuation ~ C:an Approval
Issued By ~
Permit Fees
Date 12/19/2007
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it. is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Agent/Owner
OSHKOSH
Address 665 N MAIN ST
WI 54901 - 4431 Telephone Number 231-1750
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Inspection Services Division
POBox 1130 .
Oshkosh, WI 54903-1130
Phone: (920) 2"36~SOSO
Fax:.(920) 23~5084
PlumbingPerrnitAllplication
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OJHKOfH
. \' ON THE W^TER
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I hereby apply for a pennit to do and install the folIow1ngplumbfug on theprettlises hereinafter described, the work toconf!QtrI)ilo the
Wisconsin State Plumbing Code, in theperfonnanceofwhich allparties'hereto:agr.ee tq and are bound by said statUtes. .
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· Application(s) and fee(s) can be broughlto City'llal1,:Roorii'2QS:QrmailedtoInspectionServices, PO Box 11'28,
Oshkosh WI 54903-1128. Commencing work withoutperntit(s)Willr~$ult'in fees beingdoullle9dQr $100.00 plu~th~
normal permitfee, which ever is greater; .
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OR . . ....... . . .... ...... ........ .... . .'
If VDu.are a contractor participatingint1iePermit,FfJej~:ccounJSvsiemaiid.haveddequatefuflds. check here
ifvou want this vrocessed throughvo:uracc.ountn' . . . .
"~O..'.':d,
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Patel.".....
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Number of Fixtures:
Bathtub
Whitlpool
Lavatory
Toilet
Res. Sink
Bar Sink
; Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
LocatWaste
Clothes Wshr
Bidet
Beer Tap
ClassnnBilik
.silrgeons.Sink
Breaknn~itik
DipWell
~
~.
\
~
Water Heater
o Gas.GElect 0 PwrVnt
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink'
---'--
.~
',<
----
"\
Sterilizer
Misc.
'Fixtures
....:..--.
DrinkFtn
Wait.St.
.'::,:..... Ice Chest
;Exam Sink
~~17Sink
.>>~ti~~!~~::: ".
F Prep'Shik
ServSink
.Jnt;fi.re.~ettap .
~B"tlQ~ase :Trap:
. .
. . ..R;Pi,Z:'Valve .
.~hatnp:':Sil;tk
r:lilr/ylsiSil1k.
~
.~
------
----...-
.~.
Catch Basin
WashFtn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Ice Maker
Site Drain
RQOfDrain .'
,Stiinijp Rec
.:EyeWlish'Stn
WtrSewer-Mtrs
n~di:i.qtMeters
\VittJ)sage Mtrs
,
I
".!i
Electric Contractor
. Use/N"tureofWork~Q
.OR [J]Eleetri~.Ins-tl\li~ti~n VerificatiaD:fo.r.m attached
- (ItReplace.menti '.
-\JQT, .
Size
Material
Sanitary Sewer
iStorm.Sewer..
.'-,
W.ater$ervice
TyPe
#
/6)
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4/05