HomeMy WebLinkAbout0099576-Plumbing (rp valve)CITY OF OSHKOSH
99576
No
OSHKOSHPLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address615 LEEWARD CT WESTOwnerGALLMAR INVESTMENTS LLCCreate Date01/24/2003
ContractorE C MERRILL INCCategoryPlan878-935
440 - Industrial-Interior
Bathtub0Shower0Ejector/Grind0Dip Well0F Prep Sink0Gar Drain0
Whirlpool0Floor Drain0Water Softner0Drink Ftn0Serv Sink00
Soda Disp
Lavatory00Local Waste0Wait. St.0Shamp Sink00
Lndry TrayCoffee Maker
Toilet00Clothes Wshr0Ice Chest0Flr/Wst Sink0
0
Lndry Stndp
Int Grease Trap
Res. Sink00Bidet0Exam Sink0Catch Basin0
Disposal0
Ext Grease Trap
Bar Sink000Wash Ftn0
Beer Tap0Sculry Sink
Dishwasher
Water Heater000Urinal0
Sump PumpDent. Oper.0Hand Sink
Site Drain000Standp Rec0
Classrm SinkLab Sink0Plaster Sink
Roof Drain000Ice Maker0
Breakrm SinkSterilizer0Surgeons Sink
Use/Nature Install RP Value. Device #878-935
of Work
SizeMaterialType#Conn. Type
Sanitary Sewer0
0
0
0
0
Storm Sewer0
0
0
0
0
Water Service0
0
0
0
0
$0.00
Valuation$725.00Plan ApprovalPermit Fees$20.00
Issued ByDate01/24/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Date
Signature
Agent/Owner
Address804 WITZEL AVEOSHKOSHWI54902-0000Telephone Number235-3600
City of Oshkosh
Inspection Serdces Division
P O Box 1130
Oshkosh, WI 54903-I 130
Phone: (920) 236-5050
Fax: (920) 236-5084
OJHKO/H
ON T~ WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State PIumbing Code, in the performance of w. hich all parties hereto agree to and are bound by said statutes.
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) Will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater. OR
l£vou are a contractor participating in the Permit Fee Account System and have adeauate funds
if you want this processed through your account Fl
Job Address ~:'/~'"~gg--~'~r~/~t~7-Value (lncludinglaborandmateriats)~ 7Z~-'~'~-'~ Date
Owner /~' t~ gl ~5 ~,-~' Contractor ~--~'.~--
['-]Single Family
check here
['-]Duplex [~Multi-ramily [-]Rental ['"]Commercial ~Industrial
Number of Fixtures: ......
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well FIr/Wst Sink
Lavatory Dishwasher Drink Fm Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Disp
D Gas D Elect E PwrVnt
Clothes Wshr Hand Sink Coffe~ Maker
Shower
Bidet F Prep Sink Ice Maker
Floor Drain
Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Iht Grease Trap Roof Drain
Lab Sink
Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
(If Replacement)
Use / Nature of Work /Z/~-~7",~)~.~,.~ ~ [~
Size Material Type #
[--]Electric Installation Verificatidn form attached
Sanitary Sewer
Conn. Type
Storm Sewer
Water Service
3/02