HomeMy WebLinkAbout0099938 POSHKOSH
ON THE WATER
.lob Address 1010 N WESTFIELD ST
Contractor WATTERS PLUMBING
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 1 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner EVERGREEN RETIREMENT COMM INC
Category 411 - Residential-Water Heaters
Ejector/Grind 0 DipWell 0 F Prep Sink 0
Water Softner 0 Drink Ftn 0 Serv Sink 0
LocaIWaste 0 Wait. St. 0 Shamp Sink 0
CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Bidet 0 Exam Sink 0 Catch Basin 0
Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Dent. Oper. 0 Hand Sink 0 Urinal 0
Lab Sink 0 Plaster Sink 0 Standp Rec 0
Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 99938
Create Date 02/26/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/#517/ Replace gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size
$499.00 Plan Approval $0.00 Permit Fees
Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date 02/26/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1303 MIDWAY RD, PO BOX 118 MENASHA WI 54952 - 1129 Telephone Number
800-801-8125,733-81
From:
Ciw of Galosh
Inspection Servicet Division
P O Box 1130
Oskkosh, WI $4903-1130
Phone: (920) 236-5050
Fax; (P20) 236-5084
02/24/2003 10:58 202 P.O02
Plumbing Permit Application
l hereby apply for a permit to do and msmll Ge following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, ia the performance of which all pomes hereto agree to and are bound by said statutes.
· Application(s) and fcc(s) can be brought m City Hail, Room 205 or mailed to Inspection Services, PO Box 11'28,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever i$ Heater,
OR
]_f.vou are c ¢ontractor vartict~.atinR in tJte t~_erra.ir Fee/tccount ~te.l and have qdequ~ze fa,ds, ~hect' ~e~e
[f wou want this orocessed t~;.ou~h your account ~
Job iddress__/~/~ ~//~~z~ Value/Inatudlng,ab. and.ate6nl,) ~O Date, .~~
Number of Fixtures:
Bathtub Lnd~ Standl~ Dent. Oper. Shamp Sink
Whirlpool ~ Disposal Dip Well ~ F]r/Wst Sink
L~vatof~ Dishwasher ~ I~ink Fin Catch Basin
Toilet , , Sump Pump Walt. St .... Wash Fm
RCS, Sink ' gjcctor/Onnd , , Ice Chest Urinal
Bar Sink WI~ Soflner E~m Sink Oar ~in
~aa ~ El~t 5 P~Vnt Clothes Wshr Hand S~k ,, Coff~ Maker
Shower ~ ~idet g ~ Sink
~ ~in B~r Tap 5¢~ Sink Site ~ain
~d~ T~y Cla~ Sink Iai Grease Trap _ _ R~f
~b Sink ~ Surs~ns 5ink . EXl Graas~ Trap
Plaster Si~ .... B~ak~ Sink
$mriliz~r
Eleetrlc Contractor
n]Elec~ric Installation VerificatiOn form attache(
(If Rcplacemem)
Use I Nature of Work
Sanitary Sewer
Stona
Size
Material Type # Conn. Type
Water Service
3/a2