HomeMy WebLinkAbout0102594-PlumbingOSHKOSH
ON THE WATER
Job Address 1710 GLENWOOD DR
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner JOHN R MORTH
Contractor JNL PLUMBING
Category 402 - Residential-Exterior (other)
Bathtub 0 Shower 0 Ejector/Grind
Whirlpool 0 Floor Drain 0 Water Softner
Lavatory 0 Lndry Tray 0 Local Waste
Toilet 0 LndryStndp 0 Clothes Wshr __
Res. Sink 0 Disposal 0 Bidet
Bar Sink 0 Dishwasher 0 Beer Tap
Water Heater 0 Sump Pump 0 Dent. Oper.
Site Drain 0 Classrm Sink 0 Lab Sink
Roof Drain 0 Breakrm Sink 0 Sterilizer
No 102594
Create Date 07/02/2003
Plan
0 Dip Well 0 F Prep Sink 0 Gar Drain 0
0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
0 Ice Chest 0 FIr/~Nst Sink 0 Iht Grease Trap 0
0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
0 SculrySink 0 Wash Ftn 0
0 Hand Sink 0 Urinal 0
0 Plaster Sink 0 Standp Rec 0
0 Surgeons Sink 0 Ice Maker 0
Use/Nature vlOBILE HOME/Cap off sewer & water for mobile home.
of Work
Valuation $50.00
Issued By ~'~
Size Material Type #
Sanitary Sewer Lateral
Storm Sewer
Water Service Lateral
Corm. Type
I Aband
0
0
0
0
0
0
0
0
0
Aband
0
0
0
0
Plan Approval $0.00 Permit Fees $50.00
[] Permit Voided J
DaM 0~0~2003
In the peRorrqance of~s-.~ork, I a~aree to pej:fqrm all work pursuant to rules governing the described construction.
Signature~ ~'~/~'~'~ YE// .... ~ , Date
t ~ Agen~Owner
Address 1111 Minnesota Oshkosh WI 54902 - 0000 Telephone Number
232-7270
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 penuit 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. Cormnencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account
Job Address t 7/O ~ [E.rI ~,~. Value (Including labor and materials). ~ ~" Date ¢
Owner 3o~,q ,'~p¢~,/~ Contractor .3AJC /0['~.~.;7
~}S.~ngle Family [--]Duplex ['-]Multi-Family ~]Rental l--]Commercial [--]Industrial
Number of Fixtures:
Bathtub I~dry Smndp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Fm Catch Basin
Toilet Sump Pump Wait. St. Wash Fm
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Sofmer Exam Sink Gar Drain
Water Heater ~ Local Waste Sculry Sink Soda Disp
~as Clothes Wshr Hand Sink Coffee Maker
[]
Elect
PwrVnt
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 Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work C~ff
I--]Electric Installation Verificatidn form attached
(If Replacement)
Sanitary Sewer
Size Material Type # Conn. Type
Storm Sewer
Water Service
3/02