HomeMy WebLinkAbout0100169 POSHKOSH
ON THE WATER
JobAddres$ 1018WNEWYORKAVE
Contractor GLAZE PLUMBING
Bathtub 0 Shower 0
Whirlpool 0 Floor Drain 0
Lavatory 1 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 0
Bar Sink 0 Dishwasher 0
Water Heater 0 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner FRANCIS M KOERWITZ
Category 410 - Residential-Interior
Ejector/Grind 0 DipWell 0 F Prep Sink 0
Water Softner 0 Drink Ftn 0 Serv Sink 0
LocalWaste 0 Wait. St. 0 Shamp Sink 0
ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Bidet 0 Exam Sink 0 Catch Basin 0
Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Dent. Oper. 0 Hand Sink 0 Urinal 0
Lab Sink 0 Plaster Sink 0 Standp Rec 0
Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100169
Create Date 03/06/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
Replace owner supplied pedestal lavatory.
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$600.00 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
03/12/2003
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 1865 JAMES RD OSHKOSH WI 54904 - 6873 Telephone Number
589-4014
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshl~sh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5054
D£ ELOP, E T
Plumbing Permit Application
I hereby apply for a lmmit to do and/~tall the fo/lowing pltunbing on the premises hereinafter described, the work to conform to the
Wisconsin Slate 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 Serv/ces, PO Box 1128,
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 i~ greater.
OR
I~vou arg-a cx>'ntracto~ ~avtici~ati~ in the Permit FeeAccounLSvstem~nd hav~ ad~a~teL~tnd~ eh~ck here
~ngle Family I-]Duplex ~-]MultbFamily ~']Rental ~]Commercial [~]lndustrial
Number of Fixtures:
Whirlpool Dislmml D/p Well · Flr/Wst Sink
' .
Lavatory ~ Dishwasher Cra?nit Fm ~ Catclt ~
Toilet ~ Sump Pump ~ wait. St. Wash Fm
Rm. Sink Ej~torlOrind lc, Chest Urinal
Hat Sink . ~ Waler Sofmer Exam Sink ~ar Drain
Wa~n' Heater ~ Local Wastg ~ Sculry Sink ~ SoOa Di~
~ Oas ~3 Elect ~ PwrVnt Clothea Wshr Hand Sink Coffee Maker
~shoWvr Bide~ F Prep Sink lee Maker
Floor Drain ~ Be~ Tap Scrv Sink Site Drain
Lmby Tray Classrm S/ak ~ Iht Grease Trap ..... Roof DwJn
Lab Sink ~ Surgeons Sink _ .. Ext Grease Trap .... Slandp Ree
Phsa~r SWk ~ Breaknn Sink
Electric Contractor
Use / Nature of Work
Sanitary Sewer
Swarm S~we~
Water Service
Size
I~lectric Installation Veriflcatign form attached
(If Replacememt)
/