HomeMy WebLinkAbout0102263 POSHKOSH
ON THE WATER
.lob Address 2822 OREGON ST
Contractor
Bathtub 0
Whirlpool 0
Lavatory 0
Toilet 0
Res. Sink 0
Bar Sink 0
Water Heater 0
Site Drain 0
Roof Drain 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
KIENAST L G UTILITY CONSTRUCTION
Shower 0
Floor Drain 0
Lndry Tray 0
Lndry Stndp 0
Disposal 0
Dishwasher 0
Sump Pump 0
Classrm Sink 0
Breakrm Sink 0
Owner LUVERN KIENAST
Category 430 - Industrial-Exterior (laterals)
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 102263
Create Date 06/18/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature Auto
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer 6"
Water Service
Size
Material Type #
Plastic Lateral
$1,000.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
1 Repair
0
0
0
0
0
0
0
0
0
$25.00
Date
06/18/2003
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 765 N WASHBURN OSHKOSH WI 54904 - 0000 Telephone Number
414-231-0898
No 102263
OSHKOSH
ON THE WATER
Job Address 2822 OREGON ST
Contractor KIENAST L G UTILITY CONSTRUCT[ON
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner LUVERN KIENAST
Category 430 - Industrial-Exterior (laterals)
Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 0 F Prep Sink __
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink
Lavatory 0 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink __
Toitet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink __
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin __
Bar Sink 0 Dishwasher 0 Beer Tap 0 Sculry Sink 0 Wash Ftn
Water Heater 0 Sump Pump 0 Dent. Oper. 0 Hand Sink .... ~ Urinal
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec __
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker
Create Date 06/18/2003
Plan
0 Gar Drain
0 Soda Disp
0 Coffee Maker
0 Int Grease Trap
0 Ext Grease Trap
0
0
0
0
Use/Nature Irian's Auto
of Work
Sanitary Sewer
Size
Material Type #
Conn. Type
0
0
0
0
0
Storm Sewer
Plastic Lateral
Repai[
0
0
0
0
Water Service
Valuation $1,000.00 Plan Approval $0.00 Permit Fees $25.00
Issued By ~
[] Permit Voi¢~ed~
Date 06/18/2003
In the performance o~this work, I agree to perform ~ work pursuant to rules governing the described construction.
' ' Agent/Owner
Address 765 N WASHBURN OSHKOSH WI 54904 - 0000 Telephone Number
414-231-0898
City of Oshkosh
Inspection Services Division
POBox I130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
Plumbing Permit Application
I hereby apply for a perrdt 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 pc~nnit(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
if you want this processed through Four account [~
Job Address ~ ~/~-~,~ Value (lncludinglaborand~aterials) 4 ~' CO~ Date~-/o~rO ~
Owner j~/'&:~ 'S .~d/-d "~ Contractor ,,,~d~.r'/c~..~_~2--' -
[~Single Family [--]Duplex [~Multi-Family [-]Rental <:~L~ommercial ~]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Op~r. Sham~ Sink
Whirlpool Disposal Dip Well Flr/Wst Sink ·
Lavatory Dish~vasher Drink Ftn Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Disp
D Gas ~3 Elect D PwrVnt
Clothes Wshr Hand Sink Coffee Maker
Shower
Bidet F Prep Sink lee Mak~
Floor Drain
Beer Tap Serf 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
OR
[~Electric Installation Verification form attached
(If Replacement)
Size Material Type
Sanitary Sewer
sto Sewer
Water Service
Corm. Type
3/02