HomeMy WebLinkAbout0134116-Plumbing (cross-connection)OSHKOSH
ON THE WATER
Job Address 3515 N MAIN ST
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Contractor SAMMONS PLUMBING
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
UseMature
of Work
Valuation
Issued By
Owner JANESCOINC
Category 440 -Industrial-Interior
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest Flr/Wst Sink
Lndry Tray Clothes Wshr Exam Sink Catch Basin
Disposal Bidet Sculry Sink Wash Ftn
Dishwasher Beer Tap Hand Sink Urinal
Sump Pump Lab Sink Plaster Sink Standp Rec
Classrm Sink Sterilizer Surgeons Sink Ice Maker
Breakrm Sink Dip Well F Prep Sink Gar Drain
Ejector/Grind _ Drink Ftn Serv Sink Soda Disp
Date 11/19/2008
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
Address 522 W. MURDOCK AVE
T. ..L ~J..I_ ,_____a.___ _ ..
Agent/Owner
OSHKOSH WI 54901 - 2298 Telephone Number 231-9880
• - --••~~~•o •••a~...~..~~~ N~Qa~n man ore rnspecnon reequest nne 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 pertormed within two business days from the time the project is ready.
No 134116
Create Date 11/19/2008
Plan
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
$250.00 Plan Approval $0.00 Permit Fees $25.00 ^ Permit Voided