HomeMy WebLinkAbout0101620-Plumbing (sump pump)OSHKOSH
ON THE WATER
,Job Address 845 GROVE ST
Contractor M P KELLY
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 SHIRLEY L EVANS-GUSSERT
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 101620
Create Date 05/19/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replaced sump pump.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$260.00 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
05/19/2003
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 665 N MAIN ST OSHKOSH WI 54901 - 4431 Telephone Number
231-1750
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236.5050
Fax: (920) 236.5094
DE?A.R. TMENT
Plumbing Perm,! llf;ation
OJl,KQfH
ON THF WATER
I hereby apply for a permit to do and install the followi.ng 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 stalutes.
· 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. Co.mmencing 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, particit~atin-'g in th. e per_m_it Fee A_c~count ,S.vstem and have adequate,funds, check here
if Fo.u want,this.processed throuyth.vour account [-]
Job Address .~~ ~ Value (Including laborand rraterials}_._~_~ ., Date
~ingle Family [~DuPlex [-'[Multi-Family [~]Rental [--]c0mmerclal ['-]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/'Wst Sink
lavatory Dishwasher Drink Fm CaSh Basin
Toilet , , Sump Pump
Wait.
St.
Wash
Fm
R~. Sink Ej~toffOrind Ice Chest Urinal
Water Soflner Exam Sink ~ Drain
Bar Sink ,
Water Heater Local Waste Sculry Sink ~da Disp
0 Cms r~ Elect O Pwr~t Clothes Wshr Hand Sink Coffee Maker
Shower ,,, Bidel F Prep Sink lee Maker
Floor Drain Bee~.Tap Serv Sink Si~e l~-ain
Lndry Tray , Classtm Sink Int Grease Trap Root'Drain
Lab Sink Surgeons Sink Ext Grease Trap Slandp Rea
Plaster Sink Breakrm Sink
Stm'ilizer ,
Electric Contractor
(If Replacement)
-i/ //I
Si/'e Material Type # Corm; Type
Sanitary Sewer
Storm Sewer
Water Service
,OR ['-]Electric Installation Verifleati5n form attached
3/02