HomeMy WebLinkAbout0101265 POSHKOSH
ON THE WATER
,Job Address 1817 OHIO ST
Contractor MERTEN PLUMBING
Bathtub 0 Shower
Whirlpool 0 Floor Drain
Lavatory 0 Lndry Tray
Toilet 0 Lndry Stndp
Res. Sink 0 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 MAGDALEN M DIENER
Category 411 - Residential-Water Heaters
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
0 WaterSoftner 0 Drink Ftn 0 ServSink 0
0 Local Waste 0 Wait. St. 0 ShampSink 0
0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
0 Bidet 0 Exam Sink 0 Catch Basin 0
0 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 101265
Create Date 05/05/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Install gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$450.00 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
05/05/2003
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 1087 COZY LANE OSHKOSH WI 54901 - 0000 Telephone Number
231-6795
of O~kosh
~x:tion Services Division
~Box 1
O~kmk WI ~4903-1130
(920) 236-5050
~920) Z36-5084
O./1---IKO/H
ON THI~ WATER
Plumbing Permit Application
7 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 a~ee to and are bound by said statutes.
Pq~plication(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oskkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
aorma[ permit fee, which ever is greater.
OR
are a contractor participating in the Permit Fee Account System and have adequate funds, check here
want this processed through your account
Date
[--]Industrial
~taber of Fixtures:
~ I. adxy Standp Dent Oper. Shamp Sink
~ Disposal Dip We~ Flr~st Sink
~ ~h~ ~nk Fm Catch B~in
~ S~ Pu~ Wai~ St W~h Fm
~. S~ Ej~/~nd Ice ~ Urinal
~ $i~ Wa~ Sofmer ~ S~ ~r ~in
~ H~ ~ W~te Scu~ S~ S~a Di~
D E~t ~ ~Vnt ~o~ Wshr ~d S~ Coff~ Mak~
~ Bid~ F ~ S~ Ice Mak~
~ ~M ~ Tap ~ SMk Site ~in
~Tmy C~ Sink ~t G~ Imp R~f ~in
~ S~k S~ns Sink ~ ~ Trap Smndp R~
~ $i~ Bm Sink
~EC~tric Contractor
USe / Nature of Work
[~Electric Installation Verificati6n form attached
(If Replacement)
~ailary Sewer
Sewer
Size
Material
Type
# Conn. Type
3/02