HomeMy WebLinkAbout0099750-Plumbing (toilet)OSHKOSH
ON THE WATER
Job Address 130 W 19TH AVE
Contractor M P KELLY
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner MARY E JACKSON
Category 410 - Residential-Interior
No 99750
Create Date 02/10/2003
Plan
Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp
Lavatory 0 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker
Toilet 1 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap __
Bar Sink 0 Dishwasher 0 Beer Tap 0 Sculry Sink 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
Use/Nature SFPJ Replace toilet.
of Work
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
Valuation $508.00 Plan Approval $0.00 PermitFees $20.00
Issued By
Date
02/10/2003
[] 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 Servf~es Division
P O Box 1130-
Oshkosh(WI $4903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
RECEIVED
FEB 1 0 200
EPARTMENT OF
Plumbing
Q/t OJ'H
ON 1'1-11: WATI~a
I hereby apply for a permit to do and install the followi.ng plumbing on the prenUses 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. Com~. eneing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
!f ¥ou are a contractor participating in the Permit Fee/fccount System and have adequate funds, check here
if you want this proc. eased, through your account ["]
oO
Job Address /~) ~J/'/~'~'~ ~ Value (including labor and materials, _ ,~' _
Owner ~~ ~~ Contractor
g ' . /~ /' - ,
!~ Family ~Dnplex ~Muiti-Family ~Rentai ~Comm~relal
[-]Indus~ial
Number of Fixtures:
Bathtub L~T Standp Dem. Opet.
Whirlpool Disposal Dip Well
Lavatory Dishwasher Drink Fm
, / , Sump Pump Wait. St.
Toilet
Res. Sink Ejector/Grind Ice Chest
Bm' Sink Water Soflner Exam Sink
Water Heater Lecal Waste Sculry Sink
~~ O Elect r:l PwtVnt Clothes Wshr Hand Sink
Shower Bidet F Prep Sink
Floor Drain Beet Tap Sen, Sink
Lndty Tray C'lassrm Sink Iht Grease Trap
Lab Sink Surgeons Sink Ext Grease Trap
Plaster Sink Breakfl'~ Sink
Sterilizer
s~ Sink
Flt/Wst Sink
Catch ~
Wash Fm
U~al
Ceffee Maker
Site Dram
Reef Dina
Sm~d~ Ree
Electric Contractor
Use / Nature of Work
Sanitary Sewer.
Size Material
[-']Electric Installation Veriflentidn form attached
ff__(lf Replacement)
Type # Conn. Typ~
Storm Sewer
Water Service
3/02