HomeMy WebLinkAbout0100581 P CITY OF OSHKOSH
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
JobAddress 2401 2405 PATRIOT LN Owner
Contractor WATTERS PLUMBING Category 410 - Residential-Interior
Bathtub 2 Shower 4 Ejector/Grind 0 DipWell 0 F Prep Sink
Whirlpool 0 Floor Drain 2 Water Softner 0 Drink Ftn 0 Serv Sink
Lavatory 8 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink
Toilet 6 Lndry Stndp 0 CIothesWshr 2 Ice Chest 0 FIrNVst Sink
Res. Sink 2 Disposal 2 Bidet 0 Exam Sink 0 Catch Basin
Bar Sink 0 Dishwasher 2 Beer Tap 0 SculrySink 0 Wash Ftn
Water Heater 2 Sump Pump 2 Dent. Oper. 0 Hand Sink 0 Urinal
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker
No 100581
Create Date 04/02/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature DUPLEX
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$11,364.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$204.00
Date 04/02~2003
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 1303 MIDWAY RD, PO BOX 118 MENASHA WI 54952 - 1129 Telephone Number
800-801-8125,733-81
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
RECEIVED
MAR 2 7 200;
DEPART JENT OF
COW v UN T¥ DEVELO? ENT
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
If you are a contractor participating in the Permit Fee Account System and have adequate .funds, check here
if You want this processed through your acco'unt ~
Job Address 2'jt~5- ~t'~ / /~0;4g,~ Value (Including labor and materials)
Owner /~, ~,~?~/ ~..., / Contractor
[-]Single Family [~-]Duplex [--]Multi-Family [--]Rental [--]Commercial
Date
['-]Industrial
Number of Fixtures:
Bathtub 2 Lndw Standp Dent. Oper.
Whirlpool Disposal 2. Dip Well
Lavatory ~ Dishwasher ~ Drink Ftn
Toilet ~, Sump Pump ~- Wait. St.
Res. Sink 2 Ejector/Grind lee Chest
Bar Sink Water Sofmer Exam Sink
Water Heater ~2. Local Waste Sculry Sink
~ Gas [] Elect ~ PwrVnt Clothes Wshr ~ Hand Sink
Shower ~ ~ Bidet' F Prep Sink
Floor Drain '2- Beer Tap Serv Sink '
Lndry Tray Classrm Sink Int Grease Trap
Lab Sink Surgeons Sink Ext Grease Trap
Plaster Sink Breakrm Sink
Sterilizer
Shamp Sink
Flr/Wst Sink
Catch Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Ice Maker
Site Drain
Roof Drain
Standp Rec
Electric Contractor
Use / Nature of Work
San/tary Sewer
Storm Sewer
Water Service
[-]Electric Installation Verificatidn form attached
(If Replacement)
Size
Material
Type
# Corm. Type
3/02