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HomeMy WebLinkAbout0151705- Plumbing (storm drain) CITY OF OSHKOSH No 151705 'OSHKOSH . PLUMBING PERMIT -APPLICATION AND RECORD sc,ixN%ve ON THE WATER AU61g Job Address 1013 N LARK ST Owner BERNARD L SORENSON SR REV LIVING TRU!Create Date 08/14/ 01 Contractor D.R. HANSEN PLBG. Category 401 -Residential-Exterior(laterals) Plan 4TE Inspector Jerry Fabisch Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters Shower Lndry Tray Exam Sink Sterilizer Soda Disp Wtr Sewer Mtrs Whirlpool Sump Pump F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs Lavatory San Sump/Pump Flr/Wst Sink Bidet Site Drain Misc. Toilet Water Softner Hand Sink Urinal Wait.St. Fixtures Kit Sink Standp Rec Lab Sink Beer Tap Ice Chest Disposal Gar Drain Plaster Sink Dip Well Comm Ice Maker Dishwasher Local Waste Sculry Sink Drink Ftn Int Grease Trap Floor Drain Bar Sink Sery Sink Wash Ftn Ext Grease Trap Hose Bibb Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn Water Heater Use/Nature SFR/Replacing storm drain line of Work Size Material Type # Conn.Type Sanitary Sewer Storm Sewer 4" Plastic Lateral 1 Relay Water Service Parcel Id# 1602410000 Valuation $500.00 Plan Approval $0.00 Permit Fees $50.00 ❑ Permit Voided Issued By Date 08/15/2012 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 55 KNAPP ST OSHKOSH WI 54902 -3448 Telephone Number 233-1595 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. • J Cay of Oshkosh. Inspection Services Division (411111) P O Box 1130 Oshkosh,WI 54903-1130 Phone~(920)236-5050 Rec(920)236-5084 � - OfFi _ ArEa Plumbing Permit Application I hereby apply for a permit' to do end install the followvingplumbing onthe ptezdses hereinafter descnIed,the wink to coafarmtoflute . Wisconsin Slate Plumbing Coda,Who Pace&which all parties hereto egteeto and am bound by said statues. • Application(s)and frc(s)ca n be broahgbtto any Hall,Room 205 os auu'ledto Inspection Services,PO Box 1128,Oshkosh WI 54903-1128. Commencing work Without peuie t(s)wliiresnit in fees being doubled or$100.00 plus Ste normal parmit1 a which over is greater. OR df vatt a e a contreaetnr»Qrtfciilentiaeg f the Pe>"meit Fee e d iagpdegttgtefuflds_ eheo here t i c r o r • "Advisory-For applicable projects,as Elecnicallustallation Verification(Ely)form,signedbbythe Electrical Coatroom or al1OWed tobe eed..by tlae bo p )_ ptbe svbmit�d _:iiitfi v`� r� ishie etbe with the penult application. Applications .. . . processed for Permit sec and wilibe remand for completions , Job Address JQI rl. L c. Value letoremtwm _ t1 5.00..04., Date g,14 1 a Owner 1?)Firti P. Sor9D5on Contractor 11Rt kkan SQn 1�1 umb' Lt-C grjogie Family [Duplex © tfi FeaoilY Ottent ' DCommeteia Number of Fixtures: Benoit SalopPlnp P7 Sisk Bookiprni° Steamer San.SnmplPUa Se ntlery Sink SodaDttsp Whirlpool WaterSothaor Sent eeSink Cakes Lmmuly StpipeRee Slump Sink SSte ns& Toilet Ga FD - Surgeons-Sink Weiss Stn SttSfnk Local Waste Stehdlirer Ice Chest Disposal Bar3"mk RPZ'Vatve ContmPeMem Dishwasher. »mSisk _ Bidet T tGlossa Trap Martina Masao Sisk Dina! Daemas,e Hose 13>tsm Suck Boa Tap Sys WW1 Sm Wedrlloete a Prep Sink - .Dipper Welt Dt 7c*Metier 0O321al3t tOPaorVnt Boor S Think Pfo i ._- ...vvtr Sewer uir • Acftc W c Hand Sisk. WashFntif Wtr Usage btr Ludir Lab Sink .Cate/attain • . AtSso F6 tw Electric Contractor(for projects not requiring an EIV Form) Use/Nature of Work efp s . 0 t c • 3 4 CM r0 GI rl - S5¢e Materiel Type # .. Coon.Type • Sanitary Sewer Storm Seaver Water Service . esiea Received Time Aug. 14. 2012 7: 21AM No. 0421