HomeMy WebLinkAbout0101868-Plumbing (service sink)OSHKOSH
ON THE WATER
Job Address 175 W FERNAU AVE
Contractor ADAMS PLUMBING
CITY OF OSHKOSH No '101868
PLUMBING PERMIT - APPLICATION AND RECORD
Owner B & P ORDER OF ELKS I NC Create Date 06/02/2003
Category 440- Industrial-Interior Plan
Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink I Soda Disp 0
Lavatory 0 LndryTray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 LndryStndp 0 Clothes Wshr 0 Ice Chest 0 F]r/Wst Sink 0 Int Grease Trap 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 0 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
Use/Nature -'LKS CLUB/Extra fixture for permit #100772.
of Work
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
Valuation $400.00 Plan Approval $0.00 Per~it Fees $20.00
Issued By ~f~
Date 06/02/2003
[] Permit Voided
in the perforr~ance/~,~l f~this work, I ag~,~to perform all work pursuant to rules goveming the descdbed construction.
Signature ~1~ 'L 'T~ ,~__4 ( ,~-¢~¢?,&~..~ Date
~ ~ ~enF~ner
Address 1570 N OA~OOD OSHKOSH WI ~904 - 0000 Telephone Number
233-2661
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O. ZHKO./H
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 alt 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 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
If l;ou are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account [~
JobAddress ,1"~'0 ~'~-'--~"xO-~"'4Z3tO Value (Including labor and matehals) ~L/if~.C./0
Owner L~'-T.-~ ~/~t3 _'I~ Contractor ~r~0 ~ d~,x ~ (~ L/2~ ?
[--]Single Family [-]Duplex [~Multi-Family [--}Rental [~2ommercia~
[--]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper.
Whirlpool Disposal Dip Well
Lavatory Dishwasher Drink Fin
Toilet Sump Pump Wait. St.
Res. Sink Ejector/Grind Ice Chest
Bar Sink Water Sofmer Exam Sink
Water Heater Local Waste Sculry Sink
[3 Gas [] Elect [3 PwrVnt
Clothes Wshr Hand Sink
Shower
Bidet F Prep Sink
Floor Drain
Beer Tap Serv Sink
Lndry Tray Classrm Sink Iht Grease Trap
Lab Sink
Surgeons Sink Ext Grease Trap
Plaster Sink
Breakrm Sink
Sterilizer
Slump Sink
Flr/Wst Sink ·
Catch Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Ice Maker
Site Drain
Roof Drain
Staodp Rec
Electric Contractor OR
Use / Nature of Work /~3~ C1DO~-'q~. --~
[-]Electric Installation Verification form attached
(If Replacement)
Sanitary Sewer
Size Material Type
# Conn. Type
Storm Sewer
Water Service
3/02