HomeMy WebLinkAbout0101260-PlumbingOSHKOSH
ON THE WATER
Job Address 1338 CEAPE AVE
Contractor JIM'S PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner WALTER M DOMNIE
Category 410 - Residential-Interior
Bathtub 0 Shower 1 Ejector/Grind 0 DipWell 0 F PrepSink 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 ServSink 0
Lavatory 2 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0
Toilet 2 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 0 BeerTap 0 SculrySink 0 Wash Ftn 0
Water Heater 0 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 Braakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 101260
Create Date 05/05/2003
Plan
Gar Drain 0
Soda Disp 0
Coffee Maker 0
Int Grease Trap 0
Ext Grease Trap 0
Use/Nature SFPJ Remodel.
of Work
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
Valuation $5,000.00 Plan Approval $0.00 Permit Fees $30.00
Issued By
Date 05/05~2003
[] 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 W-6166 GREENVILLE DRIVE GREENVILLE WI 54942 - 0000 Telephone Number
757-5258 OR 757-64
05/05/2003 13:59 FAX 920
FIpr' 1~' OR Ol:02p
757 6482
Oshkosh
JIMS PLUMBING
I nspeo*;ions
9RO-R3S-S08~
~]001/001
p.1
Civ~ of Osldcosh
Inspection Services Division
P OBox 1130
Osilkosh, WI 54903-I 130
Phone: (920) 236-5050
Fax: (920) 236-~084
O/HKO/H
ON THfi
Plumbing Permit Application
hereby apply for a l~rmit to do and install the following plumbing on thc premises hereinafter de, scribed, the work to conform to the
Wisconsin State Plumbing Code, in tho pgr£ormance of which ail partie~ hereto agree to and are bound by said statutes.
e Application(s) and f~(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box l 128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fee'~ being doubled or $100.00 plus the
normal permit fcc, which ~wr is greater.
OR
.l~.y. ou are a con~ractor participating in the permi~.~e deco,at System and hove ~dequctte fFnd~t, cheek h,rC.
tf you want tht:~ proc¢$sed through your ac¢ount l~
Owner
SingleFa 'ly [~Duplex
Number of Fixtures:
Bathlub lmdry Standp
Whirlpool Dispo=al
Lavatory "~' Dishwasher
Toilet ...~.. Sump Pump
Res. Sink EJcctorlOrind
Bar Sink Water Softncv
Water Heater L~al We$1c
Gas 2~ E[ect 0 FwrVnt Clothes Wshr
~oor Drain B~e Tap
Lndry Troy C1ass~ Sink
~b Sink Surgeons Sink
Plaster Sink ~ Breakrm $ink
[-]Multi-Family [~Rental [~Commereial [--[Industrial
Dent. Open Shamp Sink
Dip Well FIrlWst Slnk
Drink Fin Catch l~asi~
Wait. St. Wash Fm
Exam Sink Gar Drain
Scnlry Sink Soda Disp
Hand Sink ........ _. Cof?~ Maker
F Prep Sink [c~ Maker
Sc~ Sink .... S{t~ ~ain
Im Grease Trap _ ._ Roof Drain
Ext Grease T~p Standp Rca
Electric Contractor
OR
]'-'[Electric Installation Verification form attached
(if Replacement)
Use I Nature of Work.
Sanitary Sewer
gtorm gewer
Water S~rvice
Matexial
Type
Conn. Type
04/12/2002 t~RI 14~04 [TX/RX NO 761'2]