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Home My WebLink About0121996-Plumbing (g) CITY OF OSHKOSH No 121996 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 21 W 15TH AVE Owner KENNETH J/TAMMY L VERMEERSCH Create Date 10/04/2006 Contractor RJ KAMPO PLBG Category 410 - Residential- Interior Plan Bathtub Shower Water Softner Wait. St. Shamp Sink Coffee Maker Whirlpool 1 Floor Drain Local Waste Ice Chest Flr/Wst Sink Int Grease Trap Lavatory 1 Lndry Tray Clothes Wshr Exam Sink Catch Basin Ext Grease Trap Toilet 1 Disposal Bidet Sculry Sink Wash Ftn RPZ Valve Res. Sink Dishwasher Beer Tap Hand Sink Urinal Eye Wash Statn Bar Sink Sump Pump Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs Water Heater Classrm Sink Sterilizer Surgeons Sink Ice Maker Deduct Meters Site Drain Breakrm Sink Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs Roof Drain Ejector /Grind Drink Ftn Sery Sink Soda Disp Misc. Fixtures Use /Nature SFR/ Bathroom remodel* converting part of the 1st floor enclosed porch into a full bath to serve the master bedroom. of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcel Id # 0305130000 Valuation $3,000.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided Issued By Date 10/11/2006 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work described in this pe appli - . on within an eas ent, the City strongly urges the permit applicant to contact the easement holder(- and t. = -cure any ne - a approvals before starting such activity. Signature Date `�Agent/Owner ZL Address 1000 S WESTLAND DR APPLETON WI 54914 - 8862 Telephone Number 730 -9600 To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may continue if the inspection is not performed within two business days from the time the project is ready. City of Oshkosh Inspection Services Division P O Box 1130 Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 O�I I�O�I I Fax: (920) 236-5084 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 ox $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 account fl Job Address/ / � j Value (Including labor and materials)36/6 Date Ai %/o / ff Owner Contractor ,mo L. 1 . y [6ingle Family ❑Duplex DMulti-Family ❑Rental ❑Commercial ❑Industrial Number of Fixtures: Bathtub Disposal Drink Ftn Catch Basin Whirlpool ,/ Dishwasher Wait. St. Wash Ftn Lavatory / Sump Pump Ice Chest Urinal Toilet / Ejector /Grind Exam Sink Gar Drain Res. Sink Water Softner Sculry Sink Soda Disp Bar Sink Local Waste Hand Sink Coffee Maker Water Heater Clothes Wshr F Prep Sink Comm. Ice Maker ❑ Gas ❑Elect ❑ PwrVnt Bidet Sery Sink Site Drain Shower Beer Tap Int Grease Trap Roof Dram Floor Drain Classrm Sink Ext Grease Trap Standp Rec Lndry Tray Surgeons Sink R.P.Z. Valve Eye Wash Stn Lab Sink Breakrm Sink Shamp Sink Wtr Sewer Mtrs Plaster Sink Dip Well P Flr/Wst Sink Deduct Meters Sterilizer Hose Bibs Wtr Usage Mtrs Misc. Fixtures Electric Contractor OR ❑Electric Installation Verification form attached (If Replacement) Use / Nature of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service 11 /05