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HomeMy WebLinkAbout1995-Plumbing~.~~ CITY OF OSHKOSH N°- 44233 PERMIT APPLICATION AND RECORD TYPE: BLDG ^ HTG ^ ELEC ^ PLBG ~ SIGN ^ ZONING FLOOD PLAIN HEIGHT ADDRESS .. ~~~ 3 PLAN NO_ OWNER ~-C.-y-- * ~~~ BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR Heat ^ A/C ^ Vent ^ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR New ^ Change ^ Temp ^ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR BT ~ WH _ Disp _ WSoft - CBasin C Lav _ Sh _ DW _ DF . _ San. Sewer WC _ FDr _ Sp _ Ur _ Storm Sewer -Sink _ LTub _ Eject _ SS _ Water Other - l~ O '© FEES: Valuation $ ~© ~ ®~ O ~ Permit Fee Paid $ Park Dedication $ ISSUED BY _ ~ Date ~ ~ SSA Final/O.P. In the performance of this work I agree to pertorm all work pursuant to rules governing the described construction. SIGNATURE ADDRESS Electric Serv AGENT/OWNER ATE ~~0~~5/ ~ TELEPHONE M ~_ STATE OF WISCONSIN ) SS WINNEHAGO COUNTY ) i i ~~~_, Name Address G being first duly sworn on oath deposes and says that he is not a licensed plumber, and that he has applied for a plumbing permit to the Plumbing Inspector of the City of Oshkosh, to do plumbing work in a home owned and occupied by him, or a home that is being constructed that is owned by him, and which will be occupied by him as his home when completed. That he is not building said home.for the purpose of sale. This affidavit is made for the purpose of complying with the provisions of the plumbing code of the City of Oshkosh and the State of Wisconsin, which provides that ail plumbing work must be done by a licensed plumber except that the plumbing work may be done by one who owns and occupies his own home providing the installation complies with the plumbing code~of the City of Oshkosh and the State of Wisconsin. This affiant understands that the Plumbing work authorized by the permit applied for, must be done only by this affiant and that he cannot employ others who are not licensed plumbers to assist with the work. Dated this ~~ day of -~.~ rGV~ 19~. Subscribed and sworn to before me this day of 19 . Notary Public, Winnebago County, Wisconsin My Commission Expiress Osh osh on the water ~ Address 1503 MAPLE AVE Contractor HOMEOWNER Bathtub Whirlpool Lavatory Toilet Res. Sink Bar Sink Water Heater Use/Nature of Work Valuation Issued By 1 Shower 1 Floor Drain 1 Lndry Tray Lndry Stndp Disposal Dishwasher 1 Sump Pump EjectoNGrind Dip Well F Prep Sink Water Softner Drink Ftn Serv Sink Local Waste Wait. St. Shamp Sink Clothes Wshr Ice Chest Flr/Wst Sink Bidet Exam Sink Catch Basin Beer Tap/Soda Sculry Slnk Wash Ftn Dent. Oper. Hand Slnk Urinal No 0000356 Create Date 03/24/95 Plan Grease Trap Receptor Other REMODEL 2ND FLOOR BATH AND REPLACE WATER HEATER ROUGH IN ONLY OF BATH FIXTURES AT THIS TIME IXTURES TO BE SET AT A LATER DATE PERMIT ISSUED FOR 6 MONTHS $1,000.00 CITI~ OF OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD Owner DANIEUPATRICIA SHEA Category 410 -Residential-Interior Permit Fees $16.00 Date 03/24/95 In the pertormance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Sanitary Sewer Storm Sewer Water Service Address 1503 MAPLE AVE Oshkosh WI 54901 - 2626 Telephone Number 426-2517 Job Address 1503 MAPLE AVE Owner DANIEUPATRICIA SHEA gory 410 -Residential-Interior Bathtub 1 Shower Whirlpool 1 Floor Drain Lavatory 1 Lndry Tray Toilet Lndry Stndp Res. Sink Disposal Bar Sink Dishwasher Water Heater 1 Sump Pump Use/Nature of Work Plumbing L~ermi4~~Work Card Permit Number -89@A999-- ~y~Z ~ s' Contractor HOMEOWNER Plan Ejector/Grind Dip Well F Prep Sink Water Softner Drink Ftn Serv Sink Local Waste Wait. St. Shamp Sink Clothes Wshr Ice Chest FINWst Sink Bidet Exam Sink Catch Basin Beer Tap/Soda Sculry Slnk Wash Ftn Dent. Oper. Hand Slnk Urinal Create Date 03/24/95 Value $1,000.00 Grease Trap Receptor Other REMODEL 2ND FLOOR BATH AND REPLACE WATER HEATER ROUGH IN ONLY OF BATH FIXTURES AT THIS TIME XTURES TO BE SET AT A LATER DATE PERMIT ISSUED FOR 6 MONTHS uate ~ ype r ~/~;~ -~-~ o~ ~ a ~~ ~~ ~ .~ Inspector ;~ (, 2A~~ C-T~ .~ pprove