HomeMy WebLinkAbout0100121-Plumbing (water heater)OSHKOSH
ON THE WATER
,Job Address 955 STARBOARD CT
Contractor M P KELLY
Bathtub 0 Shower
Whirlpool 0 Floor Drain
Lavatory 0 Lndry Tray
Toilet 0 Lndry Stndp
Res. Sink 0 Disposal
Bar Sink 0 Dishwasher
Water Heater 1 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner LARRY P KAMMHOLZ
Category 411 - Residential-Water Heaters
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
0 WaterSoftner 0 Drink Ftn 0 ServSink 0
0 Local Waste 0 Wait. St. 0 ShampSink 0
0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
0 Bidet 0 Exam Sink 0 Catch Basin 0
0 Beer Tap 0 SculrySink 0 Wash Ftn 0
0 Dent. Oper. 0 Hand Sink 0 Urinal 0
0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100121
Create Date 03/07/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$174.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date
03/07/2003
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 665 N MAIN ST OSHKOSH WI 54901 - 4431 Telephone Number
231-1750
City of Oshkosh
Inspection Services Division
P 0 Box 1130.
~,Oshkosh, WI 54903-1130
~one: (920) 236-5050
Fax: (920) 236-5084
Plumbing
I hereby apply for a permit to do and install the following plumbing on the prermses hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, in the performance of which 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. Corn?~ encing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
01~
If you are a contractor_.t~articipating in the Permit Fee Account S),stem and have adeouate_fund$, check here
if you want thi$..t~roce$$ed__tl~rou~.h your account ~'~
Owne~ /_/~D'L_~.-~r-/ ~",~,/Y~/~'//~O/Z Contractor
Date ~ ~'-6,.5
'Number of Fixtures:
Bathtub Lndry Sea,dp De~t. Oper. S~ Sink
Whirlpool l~spc~al Dip Well Iq~Wst Sink
Lavatory , Dishw~she' Drink Ft~ ~..Iteh ~
Toilet Sum~ Pump Wait. St, W#h Pta
Re~. Sink ,., EjeetoffCn'ind Ice Chest ~1
Dar Sink Watt~ Sormet Exam Sink OIt ~
W~tar I Local Waste Sculr7 Sink ~ I~
Elect D P~'Vnt ClotMs Wshr Hand Sink Ce~ Make~
Shewer B~det F Pre1) Sink ~_. lee Maber
Floor Drain l~.ar Tap Serv Sink Site I~
~ Troy CIt~ Sink Iht Grease Trap Reef Delia
Lab Sink Surgeon! Sink Ext Grease Trap ~ Rec
Plast~ Sink gre~lc~m Sink
Sterili~et
Electric Contractor
Use I Nature of Work
[-']Electric Installation VerificatiOn form attached
Storm Sewer
Water Service
Size
Material Type #
Conn. Type
3/02