HomeMy WebLinkAbout0100193-Plumbing (whirlpool tub)OSHKOSH
ON THE WATER
Job Address 1545 #314 ARBORETUM DR
Contractor DRUCKS PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner REBECCAA BOUCHER
Category 410 - Residential-Interior
Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
Whirlpool I Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 LndryTray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 LndryStndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 0 BeerTap 0 SculrySink 0 Wash Ftn 0
Water Heater 0 Sump Pump 0 Dent. Oper, 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100193
Create Date 02/26~2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap __
Use/Nature
of Work
Valuation $1,000.00
Issued By ~~ev,,..~.
3ondo/Replace whirlpool tub
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Plan Approval $0.00 Permit Fees $20.00
[] Permit Voided
Date
03/14/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address PO BOX 355 MENASHA Wt 54952 - 0000 Telephone Number
426-2654
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
ON TIlE WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises 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 1 I28,
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 is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through vou.r account ~
Job Address /,5'-'t/_V' ~0t~7-O~MN~ Value (Including labor and materials) /j tj"'r'D Date
[--]Rental [-]Commercial
Owner
[2]Single Family
~Jf~_~ w ,:t h~'~.- Contractor
[--]Duplex [~Multi-Family
]--]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool ~ Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind lce Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Disp
E Gas E Elect .'D PwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Iht Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work
[~]Electric Installation Verificati6n form attached
(If Replacement)
Sanitary Sewer
Size
Material Type #
Conn. Type
Storm Sewer
Water Service
3~02