HomeMy WebLinkAbout0100482 POSHKOSH
ON THE WATER
.lob Address 641 OTTER AVE
Contractor JEFF'S WATER REPAIR
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 HEDY R SCHWEDT REV LIVING T
Category 411 - Residential-Water Heaters
Ejector/Grind 0 DipWell 0 F Prep Sink 0
Water Soffner 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 100482
Create Date 03/28/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature DUPLEX/ Install a gas power vented water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size
$700.00 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
03/28/2003
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 N2586 HWY76 HORTONVILLE WI 54944 - 0000 Telephone Number
920-757-9732
OSHKOSH
ON THE WATER
Job Address 641 OTTER AVE
Contractor JEFF'S WATER REPAIR
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner HEDY R SCHWEDT REV LIVING T
Category 411 - Residential-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell ' 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
BarSink 0 Dishwasher 0 BeerTap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 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
No 100482
Create Date 03/28/2003
Plan
Gar Drain 0
Soda Disp 0
Coffee Maker 0
Int Grease Trap 0
Ext Grease Trap 0
Use/Nature DUPLEX/ Install a gas power vented water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type Ct
Corm. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$700.00 Plan Approval $0.00 Permit Fees $20.00
[] Permit Voided
Date 03/28/2003
In the performance of this_wor~, I agree'fola,erfor~,~ ~1 work pursuant to rules governing the described construction.
Signature ¢ /~~/',~¢~yJ~ --~ Date
'/~../yc-~ - ~/~' Agent/owner ~ ~
Address N2~,{~HWY 76 HORTONVILLE WI 54944 - 0000 Telephone Number
920-757-9732
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
ON THE ~/ATER
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.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspechon 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
I_f ¥ou are a contractor particiPating in the Permit Fee Account System and have adequate _funds, check here
(f ¥ou want this processed through your account [-]
Job Address. 6/~7//' (~"~~ _('~/~alue (Including laborand mater/als) 7~0 ..~-'~ Date
o w n o. ,, o
¢Single Family [-]Duplex r-]Multi-Family [-]Rental [--]Commercial r-]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp 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 ~<~
/~3as Local Waste Sculry Sink Soda Disp
Elect~f~-~t
Clothes Wshr Hand Sink Coffee Maker
Shower
Bidet F Prep Sink Ice Maker
Floor Drain
Beer Tap Serv Sink Site Drain
Lndry Troy Classrm Sink Int Grease Trap Roof Drain
Lab Sink
Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink
Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work
OR
[--]Electric Installation Verification form attached
(If Replacement)
Sanitary Sewer
Storm Sewer
Water Service
Size
Material Type # Conn. Type
3/02