HomeMy WebLinkAbout0106026-PlumbingCITY OF OSHKOSH
106026
No
OSHKOSHPLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address1425 KENSINGTON AVEOwnerDENNIS R/SHARON SCHNEIDERCreate Date01/12/2004
ContractorADAMS PLUMBINGCategoryPlan
410 - Residential-Interior
Bathtub0Shower1Ejector/Grind0Dip Well0F Prep Sink0Gar Drain0
Whirlpool0Floor Drain0Water Softner0Drink Ftn0Serv Sink00
Soda Disp
Lavatory10Local Waste0Wait. St.0Shamp Sink00
Lndry TrayCoffee Maker
Toilet10Clothes Wshr0Ice Chest0Flr/Wst Sink0
0
Lndry Stndp
Int Grease Trap
Res. Sink00Bidet0Exam Sink0Catch Basin0
Disposal0
Ext Grease Trap
Bar Sink000Wash Ftn0
Beer Tap0Sculry Sink
Dishwasher
RPZ Valve0
Water Heater000Urinal0
Sump PumpDent. Oper.0Hand Sink
0
Eye Wash Statn
Site Drain000Standp Rec0
Classrm SinkLab Sink0Plaster Sink
Roof Drain000Ice Maker0
Breakrm SinkSterilizer0Surgeons Sink
Use/Nature SFR/ Basement bathroom.
of Work
SizeMaterialType#Conn. Type
Sanitary Sewer0
0
0
0
0
Storm Sewer0
0
0
0
0
Water Service0
0
0
0
0
$0.00Permit Voided
Valuation$1,850.00Plan ApprovalPermit Fees$21.00
Issued ByDate01/12/2004
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.
Date
Signature
Agent/Owner
Address1570 N OAKWOODOSHKOSHWI54904-0000Telephone Number233-2661
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
Plumbing Permit Application
01HKOlH
ON THE WATER
I hereby apply for a permit 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
if you are a contractor varticiDatina in the Permit Foo e,.,.,,,,,,* c..~f,,,.. ,,,, ,7 G,... .. _.7___. _._ r , ,
Job Address_~lld$' u~i.Sl ~a 1a--~ ~~Value (Including labor and materials) /Q ~~ Date ' ~ ~'
Owner ~ ~~~ 1~1 S SC4.,,~ ~~ a1,~ Contractor r--v.~A-n~S i0~$
OSingle Family Duplex OMulti-Family Rental ^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 Fm
Res. Sink Ejector/Grind ! Ice Chest Urinal
Bar Sink Water Sooner ' Exam Sink
Gar Drain
Water Heater Local Waste ' Sculry Sink Soda Disp
^ Gas ^ Elect ^ PwrVnt
~
Shower Clothes Wshr
Hand Sink
Coffee Maker
_
Fioor Drain Bidet ~ F Pr Sink
~
Ice Maker
~~ Tray Beer Tap ' Serv Sink
' Site Drain
Lab Sink Classrm Sink Int Grease Trap Roof Drain
Plaster Sink Surgeons Sink Ext Grease Tra
p
Standp Rec
Sterilizer Breakrm Sink ', R.P.Z. Valve Eye Wash Stn
Electric Contractor '; OR Electric Installation Verification form attached
(If Replacement)
Use /Nature of Work ~C~j~SWI 1~'
0 ~.(~~ ~~~
Size Material Type # Conn. Type
Sanitary Sewer ',
Storm Sewer
i
i
Water Service
7/03