HomeMy WebLinkAbout0100630 POSHKOSH
ON THE WATER
.lob,Address 2375 PATRIOT LN
Contractor PLUFF PLUMBING
Bathtub 1 Shower
Whirlpool 0 Floor Drain
Lavatory 1 Lndry Tray
Toilet 1 Lndry Stndp
Res. Sink 0 Disposal
Bar Sink 0 Dishwasher
Water Heater 0 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner RICHARD EIDEN
Category 410 - Residential-Interior
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
0 WaterSoftner 0 Drink Ftn 0 ServSink 0
1 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 100630
Create Date 04/04/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature Condo/Finish basement bath, install laundry tray in garage.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$2,200.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$24.00
Date
04/04/2003
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 PO BOX264 DALE WI 54931 - 0264 Telephone Number
779-4884
OSHKOSH
ON THE WATER
Job Address 2375 PATRIOT LN
Contractor PLUFF PLUMBING
Bathtub 1 Shower
Whirlpool 0 Floor Drain
Lavatory 1 Lndry Tray
Toilet 1 Lndry Stndp
Res. Sink 0 Disposal
Bar Sink 0 Dishwasher
Water Heater 0 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner RICHARD EIDEN
Category 410 - Residential-Interior
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
0 Water Softner 0 Drink Ftn 0 ServSink 0
1 Local Waste 0 Wait. St. 0 Shamp Sink 0
0 Clothes Wshr 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 100630
Create Date 04/04/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap __
0
0
0
0
0
Use/Nature .~ondo/Finish basement bath, install laundry tray in garage.
of Work
Valuation
Issued By
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
Plan Approval $0.00 Permit Fees $24.00
[] Permit Voided
Date
O4/O4/2O03
In the performance of this work, I agree to. perform all work pursuant to rules governing the described construction.
Signature '__ O~vt
Date
Agent/Owner
Address PO BOX264 DALE WI 54931 - 0264 Telephone Number
779-4864
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 2-36-5050
Fax: (920) 236-5084
O/HKO/H
ON TNE 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 I 128,
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
!£¥ou want this processed through your account [-~
Job Address fi375- g.-'. Value (Including labor and materials)
Owner A'~.cx.~.y, ff?,: /ff~ Contractor/~ ~/~ ~~ ~
' ':-'/ ' ' ' u
~Single Family ~Duplex ~Multi-Family ~Rental :Commercial
[--]Industrial
Number of Fixtures:
Bathtub ~ / Lndry Standp Dent. Oper.
Whirlpool Disposal Dip Well
Lavatory I Dishwasher Drink Ftn
Toilet / Sump Pump Wait. St.
Res. Sink Ejector/Grind Ice Chest
Bar Sink Water Softner Exam Sink
Water Heater Local Waste Sculry Sink
[] Gas [] Elect [] PwrVnt Clothes Wshr Hand Sink
Shower Bidet F Prep Sink
Floor Drain 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
OR
Sanitary Sewer
Size
Material Type
[--IElectric Installation Verification form attached
(If Replacement)
# Conn. Type
Storm Sewer
Water Service
3/02