HomeMy WebLinkAbout0101221 POSHKOSH
ON THE WATER
,Job Address 739 JACKSON ST
Contractor GLAZE 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 0 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner MATTHEW E WEIDEMAN/A G GRILL
Category 410 - Residential-Interior
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
1 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 101221
Create Date 05/02/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace sump pump.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$275.00 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
05/02/2003
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 1865 JAMES RD OSHKOSH WI 54904 - 6873 Telephone Number
589-4014
Plumbing Permit
OF
I he. by apply for a t~'m/t to da and/nmtl ,
· A~Ii~s) ~ ~s) c~ bc ~ w Ci~ ~tk R~ 205 ~ ~ ~ ~~ S~ ~ ~ ~ 128,
~.~ ~rm~ ~c~n~a~ ~t~c~agt~g ,~ ~he Permit Fee ~ccounl
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Number of Fixtures:
Vadgp~o! ~ l:lt~l . Dip WeB
R~e Coat--or _~ .;
Use / Nature of Work
sanit~
Walor Scrvi~
Size
M~ T~pe
, Verificattfa form