HomeMy WebLinkAbout2003-Plumbing (laterals)OSHKOSH
ON THE WATER
Job Address 1500 ADAMS AVE
Contractor HOMEOWNER
Bathtub 0 Shower 0
Whirlpool 0 Floor Drain 0
Lavatory 0 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 0
Bar Sink 0 Dishwasher 0
Water Heater 0 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JON W/CONSTANCE WARNING
Category 401 - Residential-Exterior (laterals)
Ejector/Grind 0 DipWell 0 F Prep Sink
Water Softner 0 Drink Ftn 0 Serv Sink
Local Waste 0 Wait. St. 0 Shamp Sink
Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink
Bidet 0 Exam Sink 0 Catch Basin
Beer Tap 0 SculrySink 0 Wash Ftn
Dent. Oper. 0 Hand Sink 0 Udnal
Lab Sink 0 Plaster Sink 0 Standp Rec
Sterilizer 0 Surgeons Sink 0 Ice Maker
No 104039
Create Date 09/09/2003
Plan
0 Gar Drain 0
0 Soda Disp 0
0 Coffee Maker 0
0 Int GreaseTrap 0
0 Ext Grease Trap 0
0 RPZ Valve 0
0 EyeWash Statn 0
0
0
Use/Nature
of Work
INSTALL STORM LATERAL FOR SUMP PUMP DISCHARGE
Valuation
Issued By
Storm Water
4
Size
Material Type # Conn. Type
0
0
Plastic Lateral I New
0
0
$500.00 Plan Approval $0.00 Permit Fees
$25.00 [] PermitVoided I
Date 09/09/2003
The undersigned, in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the
principle residence of the undersigned, hereby acknowledges, per Wisconsin State Statutes, ss f45.06, that other individuals
will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing
the work involved must be covered by a permit issued to a properly licensed Master Plumber.
In the perfo~f this work, I agree to pedorm all work pursuant to rules governing the described construction.
Signatur/J~/T~ //'~ ~ Date
~ ~ ~/ AgenFOwner
Address 1500 ADAMS AVE OSHKOSH WI 54902 3316 Telephone Number
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.
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.