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HomeMy WebLinkAbout0102345-Plumbing (water heater)OSHKOSH ON THE WATER ,Job Address 40 W 14TH AVE 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 JIM POMPLUN ETAL 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 FIr/Wst 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 102345 Create Date 06/19/2003 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 # $416.00 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 06/20/2003 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 19 2003 O/HKO/H Plumbin 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 botmd 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 i~ greater. OR I[Fou are a contractor participating in the Permit Fee Account SFstern and have adequate funds, check here if you want this processed through Four account N Job Address ~/-~ / 5/¢~-~- Value (Includingiahor andrnaterials~l___~/~ '~d Owner ._~/ ~ _ /~tz~ Contractor /'~,1~. /¢110'. . ~ginngle Family E[]Dnplex F-]Multi-Family I IRental I ICommer¢~al r"]Imlnstrial Date Number of Fixtures: Bathtub Lndry Standp Dent. Oper. Shamp Sink Whirlpool Disposal Dip Well FIr/Wst Sink Lavatory Dishwasher Drink Fm Catch Basin Toilet Sump Pump Wait. St. Wash Ftn Res. Sink Ejector/Grind Icc Chest Urinal Bar Sink Water Sofmer Exam Sink Gar Drain Water Heater [ Local Waste Sculry Sink Soda Disp ~'Gas [] Elect [] PwrVnt Clothes Wshr Hand Sink Coffee Maker Shower Bidet .... F Prep Sink Ice Maker 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 [--]Electric Installation Verificatidn form attached Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service 3/02