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i CITY OF OSHKOSH No 0055046
OS OSH PLUMBING PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 1016 WINDSOR ST Owner Create Date 10/02/96
Contractor SAMMO•S PLUMBING Category 411 Residential -Water Heaters Plan
Bathtub Shower Ejector /Grind Dip Well F Prep Sink Gar Drain
Whirlpool Floor Drain Water Softner Drink Ftn Sery Sink Soda Disp
Lavatory Lndry Tray Local Waste Wait. St. Shamp Sink Coffee Maker
Toilet Lndry Stndp Clothes Wshr Ice Chest FIr/Wst Sink Int Grease Trap
Res. Sink Disposal Bidet Exam Sink Catch Basin Ext Grease Trap
Bar Sink Dishwasher Beer Tap Sculry Sink Wash Ftn
Water Heater 1 Sump Pump Dent. Oper. Hand Sink Urinal
Site Drain Classrm Sink Lab Sink Plaster Sink Standp Rec
Roof Drain Breakrm Sink Sterilizer Surgeons Sink Ice Maker
Use /Nature
of Work
size Material Type conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Valuation $400.00 Permit Fees
Issued By
Date 10/11/96
U Perrnit Voided
In the performance of this work, 1 agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 26 STONEY BI=ACH ROAD OSHKOSH WI 54901 0000 Telephone Number