HomeMy WebLinkAbout0100483 POSHKOSH
ON THE WATER
.lob Address 1901 VlNLAND ST
Contractor JEFF'S WATER REPAIR
Bathtub 0 Shower
Whirlpool 0 Floor Drain
Lavatory 0 Lndry Tray
Toilet 0 Lndry Stndp
Res. Sink 0 Disposal
Bar Sink 0 Dishwasher
Water Heater 1 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JOSEF E SATTAKEH/ZAHRA SHAFI
Category 411 - Residential-Water Heaters
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
0 WaterSoftner 0 Drink Ftn 0 ServSink 0
0 Local Waste 0 Wait. St. 0 ShampSink 0
0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
0 Bidet 0 Exam Sink 0 Catch Basin 0
0 Beer Tap 0 SculrySink 0 Wash Ftn 0
0 Dent. Oper. 0 Hand Sink 0 Urinal 0
0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100483
Create Date 03/28/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
Install a gas power vented water heater.
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
.lob Address 1901 VINLAND ST
Contractor JEFF'S WATER REPAIR
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner JOSEF E SATTAKEH/ZAHRA SHAFI
Category 411 - Residential-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 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
Bar Sink 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 LabSink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
IFF{/
No 100483
Create Date 03/28/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
Install a gas power vented water heater.
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Valuation $700.00 Plan Approval $0.00 Permit Fees $20.00
Issued By ~
Date 03/28~2003
[] Permit Voided J
In the performance of this w,e~, I agm.~,toj3erform all work pursuantJ~'~governing the described construction.
Signature ,~///~~~~ Date
Address N2~6 HWY 76 HORTONVILLE ~ 54944 - 0000 Telephone Number
920-757-9732
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-I 130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
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.
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
IJ ¥ou are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account
Job Add r ess'/2P/ff/~/~d]~~ ~/n~'al-e (Including labor and materials).
Owner"~7'/7/~ D"',"~,/~e'~J~_W/-~--,~~ Contractor
¢ingle Family [-']Duplex [--]Multi-Family ['-]Rental V-]Commercial [~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 ~7'3 Local Waste Sculry Sink Soda Disp
yGas Clothes Wshr Hand Sink Coffee Maker
Elect'~PwrVnt
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Iht Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work
Sanitary Sewer
Storm Sewer
Water Service
OR
[-~Electric Installation Verification form attached
(If Replacement)
Size
Material Type # Conn. Type
3/02