HomeMy WebLinkAbout0066936-Plumbing (remodel) 4, CITY OF OSHKOSH No 0066936
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2121 MINERVA ST Owner MIKE LA PORTE Create Date 10/21/98
Contractor HOMEOWNER Category 410 - Residential- Interior Plan
Bathtub Shower Ejector /Grind Dip Well F Prep Sink Gar Drain
Whirlpool Floor Drain Water Softner Drink Ftn Sery Sink Soda Disp
Lavatory Lndry Tray 2 Local Waste Wait. St. Shamp Sink Coffee Maker
Toilet Lndry Stndp 1 Clothes Wshr Ice Chest FIr/Wst Sink Int GreaseTrap
Res. Sink Disposal Bidet Exam Sink Catch Basin Ext Grease Trap
Bar Sink Dishwasher Beer Tap Sculry Sink Wash Ftn
Water Heater Sump Pump Dent. Oper. Hand Sink Urinal
Site Drain Class= Sink Lab Sink Plaster Sink Standp Rec
Roof Drain Breakrm Sink Sterilizer Surgeons Sink Ice Maker
Use /Nature
of Work
1) MOVE ACW TO UPPER LEVEL 2) INSTALL 2 LAUNDRY TRAYS
Size Material Type # Conn. Type
Storm Water
Valuation $430.00 Plan Approval $0.00 Permit Fees $12.00
Issued By Date 10/21/98
U Permit Voided
The undersigned, in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the
principle residence of the undersigned, hereby acknowledges, per Wisconsin State Statutes, ss 145.06, that other individuals
will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing
the work involved must be covered by a permit issued to a properly licensed Master Plumber.
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature -` -7Z; c f � - Date / 2/ �?/ k ° w "
Agent/Owner
Address 2121 MINERVA ST OSHKOSH WI 54901 - 1716 Telephone Number 233 -8869
Plumbing Work Card
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Job Addre9S itteliirkiiir Permit Number 0066936 Create Date 10/21/98
Owner MIKE LA PORTE Contractor HOMEOWNER
Category 410 - Residential- Interior Plan--— Value $430.00
htub Shower Ejector /Grind Dip Well F Prep Sink Gar Drain
Whirlpool Floor Drain Water Softner Drink Ftn Sery Sink Soda Disp
Lavatory Lndry Tray 2 Local Waste Wait. St. Shamp Sink Coffee Maker
Toilet Lndry Stndp 1 Clothes Wshr Ice Chest Fir/Wst Sink Int Grease Trap
Res. Sink Disposal Bidet Exam Sink Catch Basin Ext Grease Trap
Bar Sink Dishwasher Beer Tap Sculry Sink Wash Ftn
Water Heater Sump Pump Dent. Oper. Hand Sink Urinal
Site Drain Classrm Sink Lab Sink Plaster Sink Standp Rec
Roof Drain Breakrm Sink Sterilizer Surgeons Sink Ice Maker
Use /Nature
of Work
1) MOVE ACW TO UPPER LEVEL 2) INSTALL 2 LAUNDRY TRAYS oZ 3 3 - g eg7
Size Material Type # Conn.Type
Sanitary Sewer
C / , - /4- 3 /0' r 3 0 ,l✓
Storm Sewer
..ester Service
Date Type Inspector Li Approved
No t ¢i / 1( LifrGA
k t - 41. i* 5s
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