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CITY OF OSHKOSH No 143483
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1837 OHIO ST Owner Create Date 10/06/2010
Contractor KOCH PLUMBING Category 413 - Res - Interior (Replacement Fixtures) Plan
Bathtub 1 Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters
Shower Lndry Tray Exam Sink Sterilizer Soda Disp Wtr Sewer Mtrs
Whirlpool Sump Pump F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory 1 San Sump /Pump Flr/Wst Sink Bidet Site Drain Misc.
Toilet 1 Water Softner Hand Sink Urinal Wait. St. Fixtures
Kit Sink Standp Rec Lab Sink Beer Tap Ice Chest
Disposal Gar Drain Plaster Sink Dip Well Comm Ice Maker
Dishwasher Local Waste Sculry Sink Drink Ftn Int Grease Trap
Floor Drain Bar Sink Sery Sink Wash Ftn Ext Grease Trap
Hose Bibb Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn
Water Heater
Use /Nature Bathroom remodel.
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1407720000
Valuation �$ 00.00 Plan Approval $0.00 Permit Fees $25.00 El Permit Voided1
Issued By J Date 10/06/2010
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Agent/Owner
Address 2005 DOTY ST OSHKOSH WI 54902 - 7040 Telephone Number 920 - 231 -6661 or 235
To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
.t 06 10 08:15a Clarence Koch (920) 235 -0282 p.l
,. Ly va
Inspection Services Division . .
Os h 1
Oshkosh, WI 54903 -I130
(
Phone: (920) 236 -5050
Fax: (920) 236 -5084 _
Plumbing Permit Application ON E ATE
I hereby apply for a permit to do and install the following plumbing on the prenthes hereinafter
Wisconsin State Plumbing Code, in the pace o fah all � the
parties hereto agree to and are bound by said staprta,
• Application(s) o �iion(a) and fee(s) can be
5 Commencing n work to City Hall, Room 205 or wed to Inspection PO Box 1128, Oshkosh WI
ever is greater. pemxit(s) will result in fees being doubled err $200.00 plus the normal permit fee, which
OR
• .r t•r • ,. i' , •ti
f you want this nro e d th ro u gh w our ac z r m a d h
runt n
h
** Advisory - For applicable projects, an Elechoicai
Contractor or Homeowner (for installations allowed to p Verification. � homeow by d fitted Electrical
with the peamit application. Applications submitted without an EIV when such is
for Permit Issuance and w� be wed fax required, will not be
Job Address / 4 4 7 / Value ink m
ed .aew Z�� b
83 7
Owner , `� Date f'" /�
l�srngIe Family QD iez Contractor K. dG /� ��3Gv
°P DMniti- Family DRe8tal DCom� Dln dnstri si
Number of Fixtures:
Batlulb / Sump Pomp
Bat Si. ePlaster Sint RnofDtAn
�� Water SoRaoar Scullery Sink Soda Dim r-
Y —� Service Sink Coffee ilsla
odpipc Rea
Toilet I Garage FD —"'—'- Shoup �c Site Rain
Mt Sink Local Waite S Sink Wait= stn
Sterilhar
Disposal Bar Sink roe Chest
Disposal RPZ valve ---
>lnatrm Sink Bidet Comm Trinket
Floor Drain Mann Sink Mind rot Grease trap
Hose Bibb Rum Sink Beer Bat Grease rip
Water Heater F Prep Sink ts�e wash Stn
0 GasOElea0Pwrvnt Well
Floor Sink
Drink Run
Qotha ater Hand SiSink Wu Saver her
Lathy Clothes s W Wash Bun
Lab Sint Catch Basin Mr Usage Mtr
'— Mac Fbchates
grit Contractor (for projects not _____ �9g an EXV Form)
Nature of Work . ' s c g. /,
L � / °c'.` ' 't"`Jy'+.-J,' a ,;.AF, yj ,4r , 'ter 4:2 —
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
3 This installation is complete and may be inspected at any time.
Received Time Oct. 6. 2010 8:21AM No. 3133