HomeMy WebLinkAbout0100109 POSHKOSH
ON THE WATER
Job Address 1615
Contractor KOCH
Bathtub 0
Whirlpool 0
Lavatory 0
Toilet 0
Res. Sink 0
Bar Sink 0
Water Heater 1
Site Drain 0
Roof Drain 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
1617W NEW YORKAVE
PLUMBING
Owner THOMAS J BRINKMAN
Category 411 - Residential-Water Heaters
Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Lndry Stndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Dishwasher 0 Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100109
Create Date 03/07/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature MULTI-FAMILY/1615/Replace a gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$550.00 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 2005 DOTY ST OSHKOSH WI 54901 - 0000 Telephone Number
BUTCH (C)379-8753
C{ly of Oshkosh
lnspcc(ion Services Division
P 0 Box J 13o
Oshkosh, ~Vi 54903-1 ( 30
~hone: (920)
F~x: (920) 236-~0~4
O/HKO/H
Piumbin Permit:,Applicati0n
I hcrchy apply I~)ra permit to do and i~mall ibc fi~lh~wing phtmbing on thc premises I~etcinaflcr described, the work (o conlbrm to ll~c
Wisctmsi,} State Plumbing Code, in the pertbrmancc of which all partic.q hereto agree 1o and nrc bm,nd by said slatutes.
E]Sin~le IFamily [-{Duple~ [~Mulfi-Fnmily [~Ren~al {--{C:ommerci~l [~tndustrial
Number of Fixtures:
Bathtub ............... l.~dry Standp ..... Dent.. O?tr. , ......... Shan~ Sink
Whirlpool ........... Ois~sal ..... Dip Wall Flr~s~ Sink
l~valo~ ............ Oish~sh~ ~_. Ddnk Fm .............. CaSh D~in
To/Ici Su~ Pu~ ........... Wait. Sc W~h Fm
Rcs. Sink ~mr/~nd IFc Cheil ~ U~nal
Bar Si~ WaI~ Softer Exam Sink Gar
Wa~ I~at~ I ~[I Wss~ _ ScuI~ Sink S~a Di~
S~r . C~es Wshr Hand Sink Coffc* Maker
~r ~in Bidet .... F Pr~ Sink ...... ke
~ T~y Be~ Tap S~ Sink Site ~in
~b Sink .~ 0~ Sink Iht ~e T~p ~f
Plas~r Sink S~g~ns Sink Ex( ~a~ Tap ,,, S~ Roe
S~li~ B~ Sink
Electric Contractor OR C3
ElY form attached (If Replacement)
Sanitary Sewer
Storm Sewer
Water Scrvicc
Size Malerial Typ~ # Conn. Typo
Application(s) and fcc(s) can bc brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI
54903-! 128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the normal permit fee,
which ever is greater.
OR
Check here if you wane chis processed throuqh ),our accounc ~
[0 ]D~d ONI DNI~Nnqd HDO~ ~8~0~[0~6 rg:60 £00~/gO/EO