HomeMy WebLinkAbout0101617-Plumbing (interior)OSHKOSH
ON THE WATER
.lob Address 3151 REBECCA RUN
Contractor O'NEILL ENTERPRISE INC
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner THOMAS N RUSCH
Category 410 - Residential-Interior
Bathtub 2 Shower 1 Ejector/Grind 1 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 1 Water Soffner 0 Drink Ftn 0 Serv Sink 0
Lavatory 4 Lndry Tray 0 LocalWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 4 Lndry Stndp 0 ClothesWshr 0 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 0
No 101617
Create Date 04/14/2003
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 #
$8,000.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$108.00
Date 05/19/2003
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 5575 CTY RD N PICKETT WI 54964 - 0000 Telephone Number
428-4700 589-2007
05/18/2003 89:58
City of Oshkosh
lnspeetiota Services Division
P O Box 1130
Oshkosh. WI 54.903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
9205893016 ONEILL PAGE 02
O/HKOZH
ON THE WATER
plumbing Permit Application
I hel~by apply for a permit to do and install the following plumbing on the premises hereinafter described, the work to conform to thc
Wisconsin State Plumbing Code, i~ the performance of which all panics hereto agree to and are bound by said statutes,
Owner _~--r, o~ ~. H~-ch~(k~o~q.~e~'r Contractor T-;~,
~]Single Family' E~]Duplex [==]Multi-Family n'lRentnl E~commerci. I
Date -~o/o ~
~Industriai
Number of lqxtures:
Bathtub ;Z.. _ Sterilizer Breakrm Sink
Whirlpool Lndry Standp [ Dent. ~er.
~vato~ ~ Disposal I. Dip Well
Toilet q Dish.shin J ~ink Fin
~_ Sink [ Sump Pu~ [ Wait.
Bar Sink ~j~torlGrind Icc Chest
Wat~ H~ter [ Wat~ SoOner Exam Sink
g~ :2 EI~r~ ~3 Po~r Vent Local Waste Sculry Sink
Showe~ I
Clothes Wshr Hand Sink
Flo~ ~ain ~ Rider , _ F Prep Sink
L~ Troy B~r Tap Se~ Sink
~b $j~k ~ Cla~ Sink ~ , lin, Gr~nc ]'~p
Has~r Sink Su~eons Sink Ext Grease Trap
Electric Contractor
USe / Nature of Work
Sh~p Sink
Flr/Wst Sink
Wash Ftn
Urinal
Soda
Coffee Makcr
Icc Maker
Site ~nin
Roof ~in
Stnndp Re~
[] EIV form attached (If Replacement)
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type # Conn. Type
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 is greater.
OR
y_~ wan~_~_this~, procesaed through Four accoune ~
Ch~ck
h~r~
if