HomeMy WebLinkAbout0092674-Plumbing (laterals) CITY OF OSHKOSH No 92674
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1423 INDIGO DR Owner FLOOD HOMES Create Date 02/13/2002
Contractor BERNDT EXCAVATING Category 401 - Residential- Exterior (laterals) Plan
Bathtub 0 Shower 0 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 0 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 Flr/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
of Work
CONNECT SEW & WTR TO MOBILE HOME
Size Material Type # Conn. Type
Sanitary Sewer 4 Plastic Lateral 1 New
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
.75 Copper Lateral 1 New
i
0
0
Valuation $250.00 Plan Approval $0.00 Permit Fees $50.00
Issued By Date 02/14/2002
0 Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
Signature Date
Agent/Owner
Address 2527 W WAUKAU AVE OSHKOSH WI 54904 - 0000 Telephone Number 235 -3331
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050 Of HKOf H
Fax: (920) 236 -5084
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
Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
Job Address y,:)- lh is 0 Q Q
Value (Including labor and material 2- 6 . Da e oC / 3 - 0 a,
� Mob; Le 1 `' 2� Contractor - rya /��
Owner d (j C 1. oi /" )3�
ZSingle Family ❑Duplex ❑Multi -Family ['Rental ❑Commercial ❑Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Sham 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 Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Disp
Shower Clothes Wshr Hand Sink Coffee Maker
Floor Drain Bidet F Prep Sink Ice Maker
Lndry Tray Beer Tap Sery Sink Site Drain
Lab Sink Classrm Sink Int Grease Trap Roof Drain
Plaster Sink Surgeons Sink Ext Grease Trap Standp Rec
Sterilizer Breakrm Sink
Electric Contractor OR ❑ EIV form attached (If Replacement)
Use / Nature of Work
Size Material ype— # Conn. Type
Sanitary Sewer 11* 1%) $�
o S I /' C_
Storm Sewer
Water Service 3/4t C 0/0/9("' ) )90€ l<
• 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
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