HomeMy WebLinkAbout2002-Plumbing (basement bathroom) CITY OF OSHKOSH No 97962
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 420 REICHOW ST Owner J ARDEN TRINE Create Date 10/11/2002
Contractor GLAZE PLUMBING Category 410 - Residential- Interior Plan
Bathtub 0 Shower 1 Ejector /Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Sery Sink 0 Soda Disp 0
Lavatory 1 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 1 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
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 SFR/ Replace basement 3/4 bathroom fixtures.
of Work
Size Material Type # Conn. Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Valuation $3,550.00 Plan Approval $0.00 Permit Fees $20.00
Issued By t4■11 Date 10/11/2002
❑ 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
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C,tyofOs;t].osh — L
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Inspection Services Division fi 1 WirP, .
PO Box 11.30 ��,
Oshkosh, WI 54903 -1130 7 c OCT 2'J` P.
Phone: (920) 236 - 5050
Fax: (920) 236 - 5084 d'0 ` DEPARTMENT OF OJHKOJH
C OMMUNITY DEVELOPMENT ON THE 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
Wiszonsin 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. 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 your account f
Job Address � 2 1 (CI -1 O ST Value (Including labor and materials) 4 3 - 5 C
Date I0/(r,(crz
Owi,r 4sz& 4- T 6.1 l Contractor N -7Z - GL-A a€ 01-4IG
IIEingle Family Du p lex 14I
❑ p ❑ ult>r'Famtly ❑Rental ❑Commercial ❑Industrial
Number of Fixtures:
Bathtub Lrdry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well FlriWst Sink
Lavatory ___L._ Dishwasher
Drink Fin Catch Basin
Toilet -__(__ Sump Pump i ,_ Wait. St.
Wash Ftn
Res. Sink Ejector Grind Ice Chest Urinal
Bar Sink Water Softner _ Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Disp
Gas 2 Elect PwrVnt Clothes Wshr
Hand Sink Coffee Maker
Shower l Bidet
F Prep Sink Ice Maker
Floor Drain Bear Tap Sery Sink Site Drain
Lrtdry Tray
Ciassrr., Sink Int Grease Trap Roof Drain
Lab Sink
Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink p
Breakrm Sink
Sterilizer
Electric Contractor OR ❑Electric Installation Verification form attached
(If Replacement)
Use / Nature of Work ; s ' 3 / y , A L , „ .
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
•
3/02