HomeMy WebLinkAbout0100628-PlumbingOSHKOSH
ON THE WATER
.lob Address 417 W 14TH AVE
Contractor WATTERS PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner LISA D MARTIN
Category 410 - Residential-Interior
Bathtub 1 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 1 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 1 Lndry Stndp 0 CIothesWshr 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 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 0 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100628
Create Date 04/03/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$11,300.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date 04/03/2003
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
From: 04/03/2003 ]2:36/ 2] P,O01
CiW of Osb. kosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-I 130
Phone: (920) 236-5050
Fax: {920) 236.5084
Plumbing Permit Application
I hereby apply for a permit to do and install the'following plumbing on the p~emises hereinafter described, ~e work to conform to the
Wisconsin State Plumbing Code, in thc p~dorrmnce of which ali parties, hereto agree to and arc bound by said statutes.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box l I2S,
Oshkosh WI $a903-1128. 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 par. t[civaHng in~ t. he Permit Fee Account $~1i~¢m and have adeouate funds, check here
if )!o.u want t_hi~ l?rOCeSsed through .your accoutlt ~
Owner /q']~,~' ,~ .t /$ /a ,.73~,~5,~J Contractor /,~dl~rT'~-£$ /~£>','~)~/~6~
[~ingle Family r-]Duplex [~Mu]ti-Family r-]Rental r-'lCommer¢ial
Date. ~---q--~
r"-llndustrial
Number of Fixtures:
Ba~tu1~ / Lncl~y Smndp Dent. Op~.
Whirlpool , , Dispo~! Dip We1)
~vato~ / Dishwasher ~nk Rn
Toilet , / Su~ ~mo Wait, St,
R~. Sink Ejector/Grind Ice Chest
~ar Sink Wit~ Softer Exam Sink
Wa~ Heater ~I Waste' S¢~l~ Sink
~ Gas ~ El~t D P~V~t Ctot~ Wsht Hand Sink
Shower , , ~ide~ .,. F ~p Sink
~oor ~n B¢~ Tap Sc~ ~ink
Lnd~ Troy Class~ S~ ..... . 1m Ore, se Trap
~b Sink Sur~ Sink Ext Oren~ T~p
PI~ S(~ .... ~ak~ Sink
Electric Contractor
Use / Nature of Work
Sanitary Sewez
Storm Se~er
Water Service
Shamp Sink
Fir/War Sink
Catch Basin
Wash Fm
Urinal
Oar Drain
Soda Di~p
Coffee Ivl~ker
Ice Magg
Site ~in
Roof ~in
St~dp ~
ok
[~Electric Installation Verificafi6n form attached
(if Replacement)
Siz~
Maten~l
Type
# Conn. Type