HomeMy WebLinkAbout0101950-Plumbing (move fixtures)OSHKOSH
ON THE WATER
Job Address 450 #Cl N CAMPBELL RD
Contractor SOPER PLUMBING
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 Braakrm Sink
CITY OF OSHKOSH No 101950
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JOAN ROEHR[G Create Date 06/04/2003
Category 410- Residential-Interior Plan
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
0 Water Soffner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
1 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
1 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0 Iht Grease Trap 0
0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 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
Use/Nature ~ONDO/Move fixtures.
of Work
Valuation $1,500.00
Issued By [/~¥¢~
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
Plan Approval $0.00 Permit Fees $20.00
[] Permit Voided
Date 06/04/2003
In the performance o~ this work, I agree, to perform all work pursuant to rules governing the described construction.
S ig n at u r~ ""~"~¢~ ~-~ Agent/Owner Date
Address 2225 BURNWOOD DR Oshkosh WI 54902 - 0000 Telephone Number 426-2151
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/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 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 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) ~vill result in fees being doubled or $t00.00 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 FI
Job Address ~2
Owner ~_.¢~/
I--]Single Family I--]Duplex
Value (ln~ludi.g labor and materials) ~ ~>,. ~0
Contractor ~_-'~ ~'. /2~(~ax_/:~e/~<'
~lVlulti-Family [--]Rental [~Commercial
Date
[-']Industrial
Number of Fixtures:
Bathtub Lndry St*adp
Whirlpool Disposal
Lavatory Dishwasher
Toilet Sump Pump
Res. Sink Ejector/Grind
Bar Sink Water Sofmer
Water Heater / Local Waste
I3 Gas~Elect E] PwrVnt Clothes Wshr
Shower Bidet
Floor Drain Beer Tap
Lndry Tray /t Classrm Sink
Lab Sink Surgeons Sink
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work
Sanitary Sewer
Storm Sewer
Size Material Type
Water Service
Dent. Oper. Shamp Sink
Dip Well Flr/Wst Sink -
Drink Ftn Catch Basin
Wait. St. Wash Ftu
Ice Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink lee Makex
Serv Sink Site Drain
lnt Grease Trap Roof Drain
Ext Grease Trap Standp Ree
OR
[-]Electric Installation Verification form attached
(If Replacement)
# Conn. Type
3/02