HomeMy WebLinkAbout0105044 POSHKOSH
ON THE WATER
.lob Address 1010 N WESTFIELD ST
Contractor WATTERS PLUMBING
Bathtub 0 Shower 0
Whirlpool 0 Floor Drain 0
Lavatory 0 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 0
Bar Sink 0 Dishwasher 0
Water Heater 1 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner EVERGREEN RETIREMENT COMM INC
Category 411 - Residential-Water Heaters
No 105044
Create Date 10/30/2003
Plan
Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Beer Tap 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 0
Lab Sink 0 Plaster Sink 0 Standp Rec 0
Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature SFR/#511/ Replace gas water heater.
of Work
Size Material Type # Conn. Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Valuation $599.00 Plan Approval $0.00 Permit Fees $20.00 ~ Permit Voided
Issued By
Date 10/30/2003
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 BOX 118 MENASHA WI 54952 - 0118 Telephone Number
800-801-8125,733-81
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.
From:~ATTERS PLUMING
City of Osl~o~h
Inspection Sen, ices Division
POBox 1130
Oshkosh, WI $4903-1130
Phone: (920} 236-5050
Fax: (920) 23~084
920 733 2713
10/27/2003 09:25 #105 P.002/002
Plumbing Permit Application
I hereby apply for s garnet :o do and in, tall the following plumbing on the pr~ra~ses hereinafter described, the work to con,form to
Wisconsin Stat~ Plumbing Cod~ m ~e peffo~nce of which all pa~es he~lo a~e to and are. bo~d by said statutes.
~ Applicsgon(s) ~d fee(f) can be brought to Ci~ Hall, R~ 205 or ~iled to hsp~cfion S~ices, PO Box 1128,
Oshkosh WI 54903-1128. Co~oing work without ~it(s) ~ll result in fees being doubled Or $I 00.00 plus
noel p~t fee, w~ch ~er is geat~r.
OR
~t a~i~ ' ~ the ~erm~ ~
r r cae S ~'tem an have
t Ou want thi rocessed rou h , ur ccount ada u t~ undx / ck /tare
'Contractor
]"-]Rental r=]Commerclal [~IndustrJal
Number of Fixtures:
F Prcp Sink I:¢ Maker
..... Site D~m'
Electric Contractor ,
Use / Nature of Work...____~
Salli~ar7 Sewer
Storm Sewer
Water .%trice
Mater~l
~[Electric Installation VerificatiOn form attached
CIf R~placeme~t)
3/03