HomeMy WebLinkAbout0101911 POSHKOSH
ON THE WATER
,Job Address 1930 OREGON ST
Contractor JEFF'S WATER REPAIR
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 1 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JOHN W/SHEILA R BONESKE
Category 411 - Residential-Water Heaters
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
0 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 101911
Create Date 06/03/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
Replace gas power vented water heater.
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size
$700.00 Plan Approval $0.00 Permit Fees
Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date
06/03/2003
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 N2586 HWY76 HORTONVILLE WI 54944 - 0000 Telephone Number
920-757-9732
OSHKOSH
ON THE WATER
Job Address 1930 OREGON ST
Contractor JEFF'S WATER REPAIR
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 I Sump Pump --
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink __
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner JOHN W/SHEILA R BONESKE
Category 411 - Residential-Water Heaters
0 Ejector/Grind 0 Dip Well 0 F prep Sink __
0 Water Softner 0 Drink Ftn 0 Serv Sink
0 Local Waste 0 Wait. St. 0 Shamp Sink __
0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink __
0 Bidet 0 Exam Sink 0 Catch Basin __
0 Beer Tap 0 SculrySink 0 Wash Ftn
0 Dent. Oper. 0 Hand Sink 0 Urinal
0 Lab Sink 0 Plaster Sink 0 Standp Rec __
0 Sterilizer 0 Surgeons Sink 0 Ice Maker
No 101911
Create Date 06/03/2003
Plan
0 Gar Drain 0
0 Soda Disp 0
0 Coffee Maker 0
0 Int GreaseTrap 0
0 Ext GreaseTrap 0
0
0
0
0
Use/Nature
of Work
IFF{/ Replac~ gas power vented water heater.
Sanitary Sewer
Size
Material Type #
Conn. Type
0
0
0
0
0
Storm Sewer
Water Service
0
0
0
0
0
Valuation $700.00 Plan Approval $0,00 Permit Fees $20,00
ByYW~ Date 06/03/2003
Issued
[] Permit Voidedj
In the pe[fo[mjance of this wo~ agr~,e/~p pe~o..~ all_w.o~ p~p~suant to r~.q~rning the described construction.
Signature ~j~ /~/_~_~~~~ Date
Address N258~-~Y 76~ HORTONVILLE WI 5~944 - 0000 Telephone Number e20-757-9732
City of Oshkosh
Inspection Services Division
POBox 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,/n the performance of which all parties hereto al~'ee 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) wilt 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
if you want this processed through your account
Job Address /?~f ~/~_~/~ .~alue-- (Inc,uding labor and rmteri,1,) 7f ? ?" Date_
Owner
~ingle Family [-]Duplex [-]Multi-Family [~l~nt~l ~]Commercial I Ilndustrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well FlrfWst Sink
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait. St. Wash Fm
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Wa er Heater ~ Local Waste Sculry Sink Soda Disp
Bas [2 Elect t Clothes Wshr Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Iht Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work
OR
~'-IElectric Installation Verification form attached
(If Replacement)
Sanitary Sewer
Storm Sewer
Water Service
Size
Material Type # Conn. Type
3/02