HomeMy WebLinkAbout0104125 POSHKOSH
ON THE WATER
,Job Address 693 N MAIN ST
Contractor M P KELLY
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner GRACE BROWN
Category 410 - Residential-Interior
No 104125
Create Date 09/11/2003
Plan
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Soffner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 0 Lndry Tray 0 LocalWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 1 Lndry Stndp 0 ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0 RPZValve 0
Water Heater 0 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 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
Use/Nature COMM/ Tavern/ Replace toilet.
of Work
Size Material Type # Conn. Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Valuation $298.00 Plan Approval $0.00 Permit Fees $20.00 ~J Permit Voided
Issued By
Date
09/11/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 665 N MAIN ST OSHKOSH WI 54901 - 4431 Telephone Number
231-1750
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
RECEiVeD
DEPARTMenT_ OF .._
mu m n
OJHKOJH
I hereby apply for a permit to do and install the followi.ng plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, in the performance of which all patlies 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 ii ~eater.
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 [~
JobAddress ff_~ ~C~ ,~1//1~ Valne(mcludin, l~bo~andmatcaalsLC~3~'~
Owner ~~ Contractor
E]single Family F-IDnplex ~ulti-Flmily
Date
Number of Fixtures:
Bathtub Ladry Standp Dcm. Open Shamp Sink
Whirlpool Disposal Dip Well FIr/Wst Sink
Lavatory Dishwasher Drink Fm Catch Basin
Toilet f Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Sofmer Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Disp
r' Gas D Elect D pwrVnt Clothes Wshr Hand Sink Cofl'¢¢ Maker
Shower Bidet .... F Prep Sink lee Maker
Floor Drain Beer Tap Sew Sink Site Drain
Ladry Troy Classrm Sink Int Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
(If Replacement)
~ze Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
O-R [-].Electric Instalhition Verificati6n form attached
3/02