HomeMy WebLinkAbout0100772-PlumbingOSHKOSH
ON THE WATER
Job Address 175 W FERNAU AVE
Contractor ADAMS PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner B & P ORDER OF ELKS INC
Category 440- Industrial-Interior
Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 0 F PrepSink 0
Whirlpool 0 Floor Drain 2 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 2 LndryTray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 2 LndryStndp 0 Clothes Wshr 0 Ice Chest 0 FIrNVst Sink 0
Res. Sink 1 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 0 BeerTap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 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 100772
Create Date 04/11/2003
Plan
Gar Drain 0
Soda Disp 0
Coffee Maker 0
Int Grease Trap 0
Ext Grease Trap 0
Use/Nature Electric water heater*Seperate electrical permit to be taken out.
of Work
Valuation $3,200.00
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 $48.00
Date 04111/2003
[] Permit Voided
In the performan ,of this work, I agree, to perform all work pursuant to rules governing the described construction.
Signature ~ ~nt/Owner
Date
Address 1570 N OAKWOOD OSHKOSH WI 54904 - 0000 Telephone Number
233-2661
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-I t30
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
OKI 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 account ~]
Job Address. i'7 ~- ~A,.~, ~-L~l.t~aaO Value (Including labor and matefials)
Owner ].~'-')._ 1.4.~ _(~ L ~xt~ Contractor
~-lSingle Family nDuplex E~]Multi-Family [~]Rental nCommercial
Date~--/~ //-03
~]Industrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
t3 Gas~lect [] PwrVnt
Shower
Floor D~ain ~
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Lndry Standp Dent. Oper. Shamp Sink
Disposal Dip Well Flr/Wst Sink
Dishwasher Drink Ftn Catch Basin
Sump Pump Wait. St. Wash Ftn
Ejector/Grind Ice Chest Urinal
Water Softaer Exam Sink Gar Drain
Local Waste Sculry Sink Soda Disp
Clothes Wshr Hand Sink Coffee Maker
Bidet F Prep Sink Ice Maker
Beer Tap Serv Sink Site Drain
Classrm Sink Int Grease Trap Roof Drain
Surgeons Sink Ext Grease Trap Standp Rec
Breakrm Sink
Electric Contractor
Use / Nature of Work
OR
[-1Electric Installation Verification form attached
(If Replacement)
~ Si
Sanitary Sewer
Storm Sewer
\
Water Service ....
3/02