HomeMy WebLinkAbout0101399-Plumbing (interior)OSHKOSH
ON THE WATER
Job Address 1661 MINNESOTA ST
Contractor JNL PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner MARY K HELM
Category 410 - Residential-Interior
Bathtub I Shower 0 Ejector/Grind 0 DipWell 0 F PrepSink 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 ServSink 0
Lavatory 1 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0
Toilet 1 LndryStndp 1 ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 1 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
BarSink 0 Dishwasher 0 BeerTap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 Sump Pump 0 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 0
No 101399
Create Date 05/12/2003
Plan
Gar Drain 0
Soda Disp 0
Coffee Maker 0
Int Grease Trap 0
Ext Grease Trap 0
Use/Nature IDUPLEX
of Work
Valuation $2,000.00
Issued By ~r[
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Plan Approval $0.00 Permit Fees $36.00
[] Permit Voided J
Date 05/12/2003
Date
In the performance of t_~his work, I agree to_perform all work pursuant to rules governing the described construction.
natur~ ,~~'' ~'''~''~'~'-'~-~-~ ~ Age nt/Owner
S ig
Address 1111 Minnesota Oshkosh WI 54902 - 0000 Telephone Number
232-7270
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
ON THE WATER
Plumbing Permit Application
I hereby 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 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 I 128,
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 is greater.
.OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
(f you want this processed through your account
Job Address
Owner
[--]Single Family
e,,,',oe~5~ l~ea ;~ Value (Including labor and materials)~~
~4~ (rvx Contractor
[X~Duplex r-]Multi-Family [--]Rental [-~Co~me~cial
Date
[-]Industrial
Number of Fixtures:
Bathtub
Whirlpool
~vato~y
Toilet
Res. Sink
Bar Sink
Water Heater
~Gas [] Elect [] PwrV~t
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Lndry Standp Dent. Oper. Shamp Sink
Disposal Dip Well Flr/Wst Sink
Dishwasher Drink Ftn Catch Basin
Sump Pump Wait. St. Wash Ftn
Ejector/Grind Ice Chest Urinal
Water Softner Exam Sink Gar Drain
Local Waste Sculry Sink Soda Disp
Clothes Wshr Hand Sink Coffee Maker
Bidet F Prep Sink Ice Maker
Beer Tap Serv Sink Site Drain
Classrm Sink Int Grease Trap Roof Drain
Surgeons Sink Ext Grease Trap Standp Rec
Breakrm Sink
Electric Contractor
Use / Nature of Work
OR
[--]Electric Installation Verification form attached
(If Replacement)
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
# Conn. Type
3/02