HomeMy WebLinkAbout0055965-Plumbing CITY OF OSHKOSH No 0055965
, 0 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2911 MONTCLAIR PL Owner RUSCH HOMES Create Date 12/05/96
Contractor HOMEOWNER Category 410 - Residential- Interior Plan
Bathtub Shower 1 Ejector /Grind Dip Well F Prep Sink Gar Drain
Whirlpool Floor Drain Water Softner Drink Ftn Sery Sink Soda Disp
Lavatory 1 Lndry Tray Local Waste Wait. St. Shamp Sink Coffee Maker
Toilet 1 Lndry Stndp Clothes Wshr Ice Chest FIr/Wst Sink Int GreaseTrap
Res. Sink Disposal Bidet Exam Sink Catch Basin Ext Grease Trap
Bar Sink Dishwasher Beer Tap Sculry Sink Wash Ftn
Water Heater Sump Pump Dent. Oper. Hand Sink Urinal
Site Drain Classrm Sink Lab Sink Plaster Sink Standp Rec
Roof Drain Breakrm Sink Sterilizer Surgeons Sink Ice Maker
Use /Nature
of Work finish II bathrm
Size Material Type # Conn. Type
Storm Water
Valuation $5,000.00 Plan Approval $0.00 Permit Fees $12.00
Issued By Date 12/05/96
Li Permit Voided
The undersigned, in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the
principle residence of the undersigned, hereby acknowledges, per Wisconsin State Statutes, ss 145.06, that other individuals
will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing
the work involved must be covered by a permit issued to a properly licensed Master Plumber.
In the performance of this work, I agree to perform all work pursuant to rule overning the descri ed construction. ,,
Signature Q Z,I (!� i � -'� ti���s b.
'�(_, Date � f� . ' 2. 6.7
Agent/Owner VO ut Lt. «L- at V
Address 2760 WESTMOOR RE Oshkosh WI 54904 - 0000 Telephone Number
Plumbing Permit Work Card
Job Address 2911 MONTCLAIR PL Permit Number 0055965 Create Date 12/05/96
Owner RUSCH HOMES Contractor HOMEOWNER
Category 410 - Residential- Interior Plan Value $5,000.00
htub Shower 1 Ejector /Grind Dip Well F Prep Sink Gar Drain
Whirlpool Floor Drain Water Softner Drink Ftn Sery Sink Soda Disp
Lavatory 1 Lndry Tray Local Waste Wait. St. Shamp Sink Coffee Maker
Toilet 1 Lndry Stndp Clothes Wshr Ice Chest Flr/Wst Sink Int Grease Trap
Res. Sink Disposal Bidet Exam Sink Catch Basin Ext Grease Trap
Bar Sink Dishwasher Beer Tap Sculry Sink Wash Ftn
Water Heater Sump Pump Dent. Oper. Hand Sink Urinal
Site Drain Classrm Sink Lab Sink Plaster Sink Standp Rec
Roof Drain Breakrm Sink Sterilizer Surgeons Sink Ice Maker
Use/Nature
of Work finish II bathrm
Size Material Type # Conn.Type
Sanitary Sewer
r
r
LAA - c- ° — `
1 f 7 7/ 7 7
Storm Sewer
later Service
Date Type Inspector u Approved
I) a 4 ,., ..t 3i /11 =1 A / _ g
4140.-f-z: 1/ . V.V'y 7
)._) id,i,V4-14t- c.e.107