HomeMy WebLinkAbout0105016-PlumbingOSHKOSH
ON THE WATER
.lob Address 735 JEFFERSON ST
Contractor JNL PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner BRAD C STOREY
Category 410 - Residential-Interior
No 105016
Create Date 06/11/2002
Plan
Bathtub 1 Shower 0 Ejector/Grind 0 DipWell 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 1 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 1 Lndry Stndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int 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 RPZValve 0
Water Heater 0 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash 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 Bath Remodel
of Work
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type
#
0
0
0
0
0
0
0
Conn. Type
Valuation $1,800.00 Plan Approval $0.00 Permit Fees $20.00 ~ Permit Voided
Issued By
Date
10/29/2003
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 1111 Minnesota Oshkosh WI 54902 - 0000 Telephone Number
232-7270
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 permSt 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 549034 128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
I£vou are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account [~
Owner Contractor 3t~} ~ ~J(./t~l/-q~
Dingle Family [-]Dnplex [-]Multi-Family [--]Rental ~]Commercial
Date/ -VJ
[--]Industrial
Number of Fixtures:
Bathtub } Lndry Standp Dent. Oper.
Whirlpool Disposal Dip Well
Lavatory ~ Dishwasher Drink Fm
Toilet I Sump Pump Wait. St.
Res. Sink Ejector/Grind Ice Chest
Bar Sink Water Sofmer Exam Sink
Water Heater Local Waste Sculry Sink
[] Gas [] Elect [] PwrVnt Clothes Wshr Hand Sink
Shower Bidet F Prep Sink
Floor Drain Beer Tap Serv Sink
Lndry Tray Classrm Sink lnt C, re~se Trap
Lab Sink Surgeons Sink Ext Grease Trap
Plaster Sink Bmakrm Sink R~P.Z. Valve
Sterilizer
Shamp Sink
Flr/Wst Sink
Catch Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Ice Maker
Site Drain
Roof Drain
Standp Rec
Eye Wash Sm
Electric Contractor
Use / Nature of Work
OR
[~]Electric Installation Verification form attached
(If Replacement)
Sa~tarySewer
Size
Material
Type
# Corm~ Type
Storm Sewer
Water Service
7/03