HomeMy WebLinkAbout0100851 POSHKOSH
ON THE WATER
.lob Address 916 MOUNT VERNON ST
Contractor JEFF'S WATER REPAIR
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner RICHARD A/JENNI REITZ
Category 411 - Residential-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 Water Soffner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 Lndry Tray 0 LocalWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 Lndry Stndp 0 ClothesWshr 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 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 100851
Create Date 04/17/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Install Gas Power Vented Water Heater.* Electrician unknown, seperate Electrical Permit Required.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$700.00 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
04/17/2003
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 N2586 HWY76 HORTONVILLE WI 54944 - 0000 Telephone Number
920-757-9732
OSHKOSH
ON THE WATER
.lob Address 9t6 MOUNT VERNON ST
Contractor JEFF'S WATER REPAIR
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner RICHARDNJENNI REITZ
Category 4tl - Residential-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 Water Soffner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 LndryTray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 LndryStndp 0 ClothesWshr 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 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 100851
Create Date 04/17/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Install Gas Power Vented Water Heater.* Electrician unknown, seperate Electrical Permit Required.
of Work
Valuation $700.00
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 $20,00
Date 04/17/2003
[] Permit Voided
In the performance of t.j~s work, I agree,t~?perform ail yvork pursuant to rules governing the described construction.
Date
Signature/j/~..~/.. / . ~" '""'A'g~nt/Owner
Address ~,~12586 HWY 76 HORTONVILLE WI 54944 - 0000 Telephone Number
920-757-9732
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
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 alt 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
I£¥ou are a contractor participating in the Permit Fee Account System and have adequate funds, check here
(f iou want this processed through your account N
Job Address ~/~/~&.~///~2~'~J~ue (Including labor and materials)
Owner/~~~ ./~//~'~'-~- Contractor ~'~,~
~ngle Family ~]Dnplex [--]Multi-Family [--]Rental
[--]Commercial [~Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
W~t~r Heater ~ Local Waste Sculry Sink Soda Disp
h~olwaS ID Elec~wrVnt Clothes Wshr Hand Sink Coffee Maker
er
Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Int Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor ?~ ~-~:~ ~
Use / Nature of Work
OR
[-lElectric Installation Verification form attached
(If Replacement)
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
# Conn. Type
3/02