HomeMy WebLinkAbout2003-Plumbing (sump pump)OSHKOSH
ON THE WATER
,Job Address 1675 RIVER MILL RD
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 MR/MRS CARSTON LARSON
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 ClothesWshr 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 101621
Create Date 05/19/2003
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 #
$265.00 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) 236-5084
OffHKOffH
ON ?HF W^?ER
DEP , '[ EN .C .
Plumbing
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 statutes.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1125,
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
lf F.ou are a contractor..participatin, g in the permit Fee ,4ccount.System an._~ have adequate funds, qheck here
if you want this_processed through.your account ["1
Job Address /~ ~.~' 'fi/~.ff~/~./~ a~lue (ln,l,dins
Owne~/"' ~~ ~/-x~/~ontra.ctor
['-[Rental I--]commercial r']industrial
~di~gle Family [-'[Duplex ["~Multi-Fam]ly ' ' / / ' '
Number of Fixtures:
Bathtub Lndry St~ndp De~t. Oper. Shamp Sink
Whirlpool , , Disposal Dip Well Fir/V/st Sink
Lavatory , Dishwasher ~ Drink Ftn CaSh Basin
Toilet Sump Pump / ,,. Wait. St. Wash Fin
Res. Sink , ,, Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gsr Drain
Water Heater Local Waste Sculry Sink Soda Disp
O (3ns g Elect [] PwtVnt Clothes Wshr , Hand Sink CoflL. e Maker
Shower Bidet F Prep Sink le~ Maker
Floor Drain Beer Tap Serr Sink Site Drain
Lndry Tray . .. Classrm Sink lnt Greese Trap ROOf Draln
Lab Sink - Surgeons Sink Ext Grease Trap Stamtp Rec
Plnstet Sink Breakrm Sink
Sterilizer
Electric Contractor
(If Replacement)
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
['-]Electric Installgtion VertfleattSn form attached
3/02