HomeMy WebLinkAbout0101123-Plumbing (tub & water heater)OSHKOSH
ON THE WATER
.lob Address 1095 N WESTFIELD ST
Contractor RASMUSSEN PLUMBING
Bathtub 0 Shower 0
Whirlpool 1 Floor Drain 0
Lavatory 0 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 0
Bar Sink 0 Dishwasher 0
Water Heater 1 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner EVERGREEN MANOR INC
Category 410 - Residential-Interior
Ejector/Grind 0 DipWell 0 F Prep Sink 0
Water Softner 0 Drink Ftn 0 Serv Sink 0
LocalWaste 0 Wait. St. 0 Shamp Sink 0
ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Bidet 0 Exam Sink 0 Catch Basin 0
Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Dent. Oper. 0 Hand Sink 0 Urinal 0
Lab Sink 0 Plaster Sink 0 Standp Rec 0
Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 101123
Create Date 04/29/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature CBRF/Replace bath tub & add electric water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$6,000.00 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
04/30/2003
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 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 8887 Telephone Number
920-233-6747
04/38/2003 86:49 2336747 J RASMUSSEN PAGE 01/81
P~umbing Permit Application
! ht:reby 3?p'iy fhr a pewt~d,t ¢0 do an(i ~il ;~e folto~n~ pb~mb'[~ ~n ~¢ ~e~J.~ bc~e:ii'tnf[~ de;~crlbed, the '~,o~,R
,, ' or $'100,~0 plt~s thc
tmrm~] p~it fcc, wl~ch ~x'cr i-q
[Doo.
05/02/2003 06:41 2336747 J RASMUSSEN PAGE 62/82
(1) (We) Beez Etectdc. ][ac.
h~ve been co~,,tr~.ct"-.rl to pe~!om~ ejectdc ~.~tattat. i¢l,~ ~rerk for R.~.~.u..m~.~e~ Jeff 81Ur~llb_b~_g,
The nature of the, ~?ork consists of'
(Check Ot~e ~ Desc~be the Naltllm 0flwOrk)
'.R.eccmnectioa or new dreuk for replaeemem He~ti*.g Plato and/or AIC Conden, er.
R.~onnecfon or ~,ew ch'cmI :for rep[acem~t Electric Waler Hea:t~.
Reeo~ien of the gm,flee En~}'a~ce Cable, Meter. B~, Mt~ations m receptacles and
wilt requi~ a scp,.ram pen~t.
The vM.ue o'f this work is $.)..5_0_,_0.g.
~ hereby' vefi:~'y this ,~ork will be perfermed by ~. employee ofthi.5 company and ~her v~5~ the
reconne~:ion / ~.nstallat}on ufil] be dm~e m emmpli~ce wi.th msnu:facturer ~n.d Electric code
~equiremcsts.
(Si~na.mre o'[ C~l~x~pany Officer)