HomeMy WebLinkAbout0122486-Plumbing (laterals)
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OSHKOSH
ON THE WATER
Job Address 3221 MOCKINGBIRD WAY
CITY OF OSHKOSH
No
122486
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Gri nd
Owner CHET WESENBERG Create Date 11/10/2006
Category 401 - Residential-Exterior (laterals) Plan
Water Softner Wait. St. Shamp Sink Coffee Maker
Local Waste Ice Chest FlrlWst Sink Int Grease Trap
Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
Bidet Sculry Sink Wash Ftn RPZ Valve
Beer Tap Hand Sink Urinal Eye Wash Statn
Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Sterilizer Surgeons Sink Ice Maker Deduct Meters
Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Drink Ftn Serv Sink Soda Disp
Contractor HANNA EXCAVATING
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
NSFRI Laterals
Size Material Type # Conn. Type
Sanitary Sewer 4" Plastic Lateral 1 New
Storm Sewer 4" Plastic Lateral 1 New
Water Service 1-1/4" Plastic Lateral 1 New
Parcelld #
1336110000
$2,500.00
... . $0.00 Permit Fees
$150.00 0 Permit Voided I
Plan Approval
Date 11/10/2006
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 holde to secure any ne sary approvals before starting such activity.
Signature
Date /1-/ t1' - 06
Agent/Owner
OSHKOSH
Address 2781 VILLAGE LN
WI 54904 - 0000 Telephone Number 235-6450
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
.. PO Bpx 1130
Oshkosh, WI 54903-1130
~. Phone: (920) 236-5050
r . Fax: (920) 236-5084
~
OfHKOfH
ON THE WATER
Plumbing Permit Application
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 participating in the Permit Fee Account System and have adequate funds. check here
if yOU want this processed through your account n
,;}, J' :J IJ F
Job Address 322/ rkf. r I; nfi <<1f alne (In']"d~ .boc md =,,"..) Z? cXJ
Owner Contractor I!kI /IJ~;'rl
~single Family DDuplex DMulti-Family DRental DCommercial
Date /1-/tJ -CJ6
DIndustrial
Number of Fixtures:
(i Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
o Gas 0 Elect 0 PwrVnt
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
Fixtures
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrm Sink
Surgeons Sink
Breakrm Sink
Dip Well
Hose Bibs
DrinkFtn Catch Basin
Wait.St. Wash Ftn
Ice Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink Comm. Ice Maker
Serv Sink Site Drain
Int Grease Trap Roof Drain
Ext Grease Trap Standp Rec
R.P.Z. Valve Eye Wash Stn
Shamp Sink Wtr Sewer Mtrs
Flr/Wst Sink Deduct Meters
Wtr Usage Mtrs
Electric Contractor
OR
DElectric Installation Verification form attached
(If Replacement)
Use / Nature of Work
Size Material
Sanitary Sewer ft< !tJC
(\
Storm Sewer I.) 1< ItI(.
Water Service /!1 I~L
?:Ie # connWe
ru# / !fA . ,
If / rUM
It I pu?
11/05