HomeMy WebLinkAbout0102200 POSHKOSH
ON THE WATER
,Job Address 824 OSBORN AVE
Contractor JEFF'S WATER REPAIR
Bathtub 0 Shower 0
Whirlpool 0 Floor Drain 0
Lavatory 0 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 0
Bar Sink 0 Dishwasher 0
Water Heater 1 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner PATTI L HARTENBACH
Category 411 - Residential-Water Heaters
Ejector/Grind 0 DipWell 0 F Prep Sink 0
Water Softner 0 Drink Ftn 0 Serv Sink 0
LocalWaste 0 Wait. St. 0 Shamp Sink 0
ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Bidet 0 Exam Sink 0 Catch Basin 0
Beer Tap 0 Sculry Sink 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 0
No 102200
Create Date 06/13/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace gas power vented water heater.
of Work
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
06/13/2003
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
JobAddress 824 OSBORN AVE
Contractor JEFF'S WATER REPAIR
CITY OF OSHKOSH No '102200
PLUMBING PERMIT - APPLICATION AND RECORD
Owner PATTI L HARTENBACH Create Date 06/13/2003
Category 411 - Residential-Water Heaters 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 0 Soda Disp 0
Lavatory 0 LndryTray 0 LocaIWaste 0 Wait, St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 LndryStndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Iht 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 '1 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 ~SFR/Replace gas power vented water heater.
of Work
Sanitary Sewer
Size Material Type #
Conn. Type
0
0
0
0
0
Storm Sewer
0
0
0
0
0
Water Service
Valuation $700.00
Issued By ~.~.~,
Plan Approval $0.00 Permit Fees $20.00
[] Permit Voided
Date 06/13/2003
In the performance of this v~frk, I agile t~erform all wo~-~pursua, p~to rules governing the described construction.
Signature ~~//~/~.~ Date
/ ~7/,/ V~ ~ Age~'~nt/Owner~,,.
Address N~6/HWY'76 HORTONViLLE ~' Wi 54944 - 0000 Telephone Number
990-751-9132
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 thc
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. Commcmcing work without permit(s) will 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
i[¥ou want this processed through your account
Job Address ~/~.~. ~/~ .~,,'~ae (I.c~oding labor and materials) ,~_~'7~ ?~-'' Date
Owner ~tS~.~.,,~ ~2~. ,~Q--2~*'~'~-~ .;~2- Contractor ~~._~_~'J~, ?/~
[]D.,,e¢ t .,ti-Family Commereia, ,.d.strial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well lqr/Wst Sink
Lavato~ Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait, St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Sofmer Exam Sink Gar Drain
Water Heater '~ Local Waste Sculry Sink Soda Disp
~GasQ Elect ~q~wrVn t Clothes Wshr Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain Be~r Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Int Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work
Sanitary Sewer
OR
[-lElectric Installation Verification form attached
(If Replacement)
Size
Material Type # Conn. Type
Storm Sewer
Water Service
3/02