HomeMy WebLinkAbout0102105 POSHKOSH
ON THE WATER
,Job Address 2599 VILLAGE LN
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 1 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JEFFERY/BEV RICE
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 CIothesWshr 0 Ice Chest 0 FIrNVst 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 102105
Create Date 06/11/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$455.00 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
06/11/2003
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
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
RECEIVED
JUN 0 9 2003
DEPARTMENT OF Q/HKO/H
vi'& UNITY DEVELOPMENT
Plumbing Permit Application
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 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 iR greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if Fou want this processed through Four account ~]
[--]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper.
Whirlpool Disposal Dip Well
Lavatory Dishwasher Drink Fm
Toilet Sump Pump Wait. St.
Res. Sink Ejector/Grind Ice Chest
Bar Sink Water Sofmer Exam Sink
Water Heater / Local Waste Sculry Sink
~ Gas D Elect [] PwrVnt Clothes Wshr Hand Sink
Shower Bidet ..... F Prep Sink
Floor Drain Beer Tap Serv Sink
Ladry Tray Classrm Sink Iht Grease Trap
Lab Sink Surgeons Sink Ext Grease Trap
Plaster Sink Breakrm Sink
Sterilizer
Shamp Sink
Fir/O/st Sink
Catch Basin
Wash Fm
Urinal
Oar Drain
Soda Disp
Coffi~e Maker
Ice Maker
Site Drain
Roof Drain
Standp Rec
Electric Contractor
'Use / Nature of Work
Sanitary Sewer
Storm Sewer
Water Service
[-]Electric Installation Verificati6n form attached
Size Material Type #
Conn. Type
3/02