HomeMy WebLinkAbout0101267-Plumbing (interior)OSHKOSH
ON THE WATER
.lob Address 4590 SHAMBEAU DR
Contractor VALENTINE PLBG
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JASON BORGARDT
Category 410 - Residential-Interior
Bathtub 1 Shower 2 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 2 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 4 Lndry Tray 1 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 4 Lndry Stndp 0 CIothesWshr 1 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 1 Disposal 1 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 1 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 Sump Pump 1 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 1
No 101267
Create Date 03/07/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$6,500.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$126.00
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 W2015 INDUSTRIAL DR KAUKAUNA WI 54130 - 0000 Telephone Number
920-788-5369
Job Address
Owner
Category
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
~___~,Ad~t~ ~,.,~,~',~...,tl'e~J"~ T~ I~r~tract°r
~C~',~ ~~ P'~.
Shower ~ ~ Ejector/Grind Dip Well
Floor Drain ~ Water Soffner Drink Ftn
Plumbing Permit Work Card
[~)lr ~-.~ Permit Number 0000000 Create Date
Value '~ ~"'0~). 000
--~-- Lndry Tray _ I Local Waste Wait. St.
V Lndry Stndp Clothes Wshr --L Ice Chest
Disposal I _ Bidet Exam Sink
Dishwasher ~ Beer Tap Sculry Sink
~ Sump Pump ~ Dent. Oper. Hand Sink
Classrm Sink. Lab Sink Plaster Sink
Breakrm Sink sterilizer Surgeons Sink
F Prep Sink
Serv Sink
Shamp Sink
FIrANst Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type # Corm. Type
PlAY 0 5 2005
DEPARTMENT OF
¢O~uNITy DEVELOPMENT
Date
Type Inspector
~pproved