HomeMy WebLinkAbout0104881-PlumbingOSHKOSH
ON THE WATER
.lob Address 210 FARMSTEAD LN
Contractor PLUFF PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner US LAND DEVELOPMENT LLC
Category 410 - Residential-Interior
No 104881
Create Date 09/22/2003
Plan
Bathtub 1 Shower 2 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 1
Whirlpool 0 Floor Drain 1 Water Softner 1 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 3 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 4 Lndry Stndp 0 CIothesWshr 1 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Res. Sink 1 Disposal 1 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 1 Beer Tap 0 SculrySink 0 Wash Ftn 0 RPZValve 0
Water Heater 1 Sump Pump 1 Dent. Oper. 0 Hand Sink 0 Urinal 0 Eye Wash Statn 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 NSFR/ New single family bi-level with 2 car attached and 15' x 11' deck. Includes gas water heater
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 $6,900.00 Plan Approval $0.00 Permit Fees $114.00 ~ Permit Voided
Issued By
Date
10/21/2003
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address PO BOX264 DALE WI 54931 - 0264 Telephone Number
779-4884
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
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 perrrdt to do and install the following plmmbing 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 I 128,
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 is greater.
OR
lf l2ou are a contractor participating in the Permit Fee Account Systetn and have adequate £unds, check here
if you want this processed through your account [-~
Job Address ,~ I ~ Fr,:~'Te~
Owner ~-~-q'~;~ 0 ~Ti'z-
J~Single Family [~Duplex
~]Multi-Family [-]Rental [-[Commercial [~]Industrial
Number of Fixtures:
Bathtub ~ Lndry Standp
Whirlpool Disposal
Lavatory ~3 Dishwasher
Toilet q S.m Pum
Res. Sink J Ejector/Grind
Bar Sink Water Softner
Water Heater I Local Waste
~Gas O Elect [2 pwrvnt Clothes Wshr
Shower _ Bidet
Floor Drain J .. Beer Tap
Lndry Tray Classrm Sink
Lab Sink Surgeons Sink
plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work
Dent. Oper. Shamp Sink
Dip Well Flr/Wst Sink
Drink Fm Catch Basin
Wait. St. Wash Ftn
Ice Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink Ice Maker
Serv Sink Site Drain
Iht Grease Trap Roof Drain
Ext Grease Trap Standp Rec
R~P.Z. Valve Eye Wash Sm
OR
[-]Electric Installation Verification form attached
(If Replacement)
Sanitary Sewer
Storm Sesver
Water Service
Size
Material
Type
# Conn. Type
7/03