HomeMy WebLinkAbout0100767 POSHKOSH
ON THE WATER
.lob Address 4414 JACKTAR RD
Contractor KOCH PLUMBING
Bathtub 4 Shower
Whirlpool 0 Floor Drain
Lavatory 6 Lndry Tray
Toilet 4 Lndry Stndp
Res. Sink 4 Disposal
Bar Sink 0 Dishwasher
Water Heater 1 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner ANCHORAGE HOMES INC
Category 410 - Residential-Interior
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
2 WaterSoftner 0 Drink Ftn 0 ServSink 0
0 Local Waste 1 Wait. St. 0 ShampSink 0
1 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
0 Bidet 0 Exam Sink 0 Catch Basin 0
4 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 100767
Create Date 02/13/2003
Plan D2-15-0203-P
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature 4 unit
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$14,500.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$162.00
Date 04/11/2003
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 2005 DOTY ST OSHKOSH WI 54901 - 0000 Telephone Number
BUTCH (C)379-8753
City olr Osl~kosh
inspection Services I)ivh'ion
P O Box 1130
Oshkosh, %vi S4903 1130
Phone: (920) 736-5050
Fax: (920) 236-5084
'_Off, HKO/H
Plumbing Permit ApPlication
I I~creby apply £o,' a pcm~R to do and install dfc following ph,mbing on thc prcmiscs hcrcina£ter describcd~ thc work to conform m thc
Wiscon.sm State Plumbing Code, in thc pcJorma,cc of which ali panics hcrclo a&rce to and are bound by said sumtc.q.
~Single Family ~Duplex ~Multi-Fa,,,ily ~Renlal ~Commercial ~lndustrial
Date
Number of I;'ixlures;
Bathtub ... &_. Lnd~ Standp ........ L .... Dcm. Op~r. . .... Shmmp
Whidpoo! ............. Disposal ~-~ Dip W,,II Fh'/Wst Sink
Lavatocy . ,,~ .... Dishwashca' ..... ~._.. Drink Fm ..... C~h Basin
Toilm __ + . Sump Punq~ Wail. SI ........ Wash
R~. Sink __,..~ Ej<~tOr/Ofi~d ._ Ice Chei~ Urinal
Bar Sinl~ Wa~r Soflnet Exam Sink Gar Drain
Shower CIo~e~ Wslu' Ha~l Sink Coffee Maker
Floo~ Drain ~ Bidgt ~ F Pr~p Sink Ice
L~d~' Tr~y Be~ Tap S~'rv Sink ~ SRg Drain
lnb Sink Clausrm Sink {n! Orcasc Trap ~ Roof Drain
Plaster Sink Surgeons Sink I~x( Grease Trap ._.~. Standp Rog
S~.vilizer ]Brea~m Sink
Electric Contractor
IJse / Naturc of Work
,OR
ElY form attached (IfReplacemon0
Sanitary Sewer
Stoma Sewer
Water Scrvicc
Size Material Type # Conn. Typc
ApplicatiOn(s) and fcc(s) can be brought to City Hall, Room 205 or mailed to InspeCtion Services, PO Box I ! 28, OshkOsh WI
54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the normal permit fee,
which ever is greater,
OR
Check here if you wane chis ~roc~$~ed Chrouq_h,_,~ou~, accoun~ ~