HomeMy WebLinkAbout2003-Plumbing (laterals) (2) CITY OF OSHKOSH No 105380 ���� = _
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OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD � ,� `
ON THE WATER �f�
Job Address 203 PROSPECT AVE Owner NAO XIONG THAO/NENG LEE Create Date 11/18/2003
Contractor JNL PLUMBING Category 401 -Residential-Exterior(laterals) Plan
Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 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 0 Lndry Tray 0 Local Waste 0 Wait.St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 Flr/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 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Water Heater 0 Sump Pump 0 Dent.Oper. 0 Hand Sink 0 Urinal o Eye Wash Statn 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink � Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature epair elbow outside of building.
of Work
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Size Material Type # Conn.Type
Sanitary Sewer existing Plastic Lateral 1 Repair :
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Valuation $1,500.00 Plan Approvai $0.00 Permit Fees $25.00 ❑ Permit Voided�
Issued By ,�— Date 11/18/2003
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)3a�-to secure any necessary approvals before starting such activity. �
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Signature � ,�, =�>/ � Date ( ( �6' � ��
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�— AgenUOwner
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 �fHKOlH
Fax:(920)236-5084
ON THE VJATER �
Plumbing Permit Application
I hereby apply for a pernut 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 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
I�vou are a contractor participating in the Permit Fee Account Svstem and have adequate funds, check here
i�you want this processed through your account n
Job Address �� �' J ��^�'��� � �� ValUe(Including labor and materials) ��r� � Date ���/ ��UJ
OWIIeI' Contractor J /'� � �^��/M'✓���'
�Single Family ❑Duplex �Multi-Family QRental ❑Commercial ❑Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent.Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait.St. Wash Ffi
Res.Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Soffier Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Disp
0 Gas�Elect�PwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Int Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Crrease Trap Standp Rec
Plaster Sink Breakrm Sink R.P.Z.Valve Eye Wash Sm :
Sterilizer
Electric Contractor OR ❑Electric Installation Verification form attached
(If Replacement)
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Use/Nature of Work S,CJ �•�i� ,�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
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