HomeMy WebLinkAbout0100409 POSHKOSH
ON THE WATER
.lob Address 1208 N SAWYER ST
Contractor RASMUSSEN PLUMBING
Bathtub 0 Shower 0
Whirlpool 0 Floor Drain 0
Lavatory 0 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 0
Bar Sink 0 Dishwasher 0
Water Heater 1 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner HERGERT REALTY
Category 411 - Residential-Water Heaters
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 100409
Create Date 03/26/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
Duplex/Rental
/ Replace gas water heater
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size
$450.00 Plan Approval $0.00 Permit Fees
Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date
03/26/2003
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 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 8887 Telephone Number
920-233-6747
03/27/2003 87:81 2336747 J RASMUSSEN PAGE 01/01
,Jan ~R 03 le:~-5p OshKosh In~peotioms
-5084
p.1
City of Oskkosh
in.epectiori Se.~vices Division
PO Box 1130
Pllo~: (920)
Fax: [9~0) 236-5084
Plumbing Permit Application
^.pplicati~n(s) and tee(s) can be brought to City Hall, P. oom 205 or mailed m ~ection 3~Wcs, PO Box I 128,
~hkosh ~ 3~3-I I~8. Comm~c~g wor~ ~ithoat pe~it(s) ~ll ~ult in f~ ~ing dot, bled or $100.~ pl~ the
per :,it
~~,
Number of Fixtures'-
~oda Di~
7,as ~ ~ieet ~ P~Vnl C}othes ~'p~r ...... lq~ ~f~k Caf fcc Maker
Use I Nat. re of Work
Size
Matedal TEpe
~Electric ]{u~ailition VerJarfeat}b'n form str~ched
(If Rcl~l~ecrran tl