HomeMy WebLinkAbout0123447-Plumbing (room 1C425)
""O~
OSHKOSH
ON THE WATER
Job Address 500 S OAKWOOD RD
Contractor BASSETT MECHANICAL
~
"
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner MERCY MEDICAL CENTER OSH INC
C~tegory 440 - Industrial-Interior
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest FlrlWst Sink
Lndry Tray Clothes Wshr Exam Sink Catch Basin
Disposal Bidet Sculry Sink Wash Ftn
Dishwasher Beer Tap Hand Sink Urinal
Sump Pump Lab Sink Plaster Sink Standp Rec
Classrm Sink Sterilizer Surgeons Sink Ice Maker
Breakrm Sink Dip Well F Prep Sink Gar Drain
Ejector/Grind Drink Ftn Serv Sink Soda Disp
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature Install floor drain and site drain for therapy bath in room 1 C425. (check #211953)
of Work ~tate Plan Review
No 123447
Create Date 02/08/2007
Plan 1363159
Coffee Maker
IntGrease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Valuation
Issued By
Size
Conn. Type
Parcelld #
0613660000
Date 02/08/2007
Material
Type
#
Sanitary Sewer
Storm Sewer
Water Service
$5,500.00 Plan Approval
$0.00 Permit Fees
$25.00 D Permit Voided I
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
Address PO BOX 7000
Agent/Owner
KAUKAUNA
WI 54130 - 7000 Telephone Number 800-236-2502==920-
Date'
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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.
..Jul
. Po'
.
.
.
22~04
lO:02a
Oshkosh Inspections
S20-236-5084
p. 1
City ofOshko!ih
"'~pecrion Services Division
, )) Dox 1130
"Jshkosh. WI 54903-1130
Phnne: (920) 236-5050
Fa.,; (910) 236-5084
~
OfHKOJ-H
or.. rw:: VlA:-~I-"
Plumbing Permit Application
I hereby apply for a pennit 10 do and install the following plumbing on the premiseshereinafccr described, the work to conform to the
Wisconsin State Plumbing Code, in the pcrfonnancc 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 ''''ork without pennit(s) will result in fees being doubled or S 1 00.00 plus the
nom1:l1 permit fee, which ever is greater.
OR
If ~'ou are {/ contractor f)t1rticir>lltin1! in tlrl:.' Permit Fee Account S~'stelfl and have adequate funds. check here
if VOIl want this J1I(}!::e..s,s..ed tbr.oueh vnur account n
Job Address 500 s. Oakwood VaJUC{lncludingl:lbor:lndmateri:lls) 5500.00 Date 2/7/07
Owner Mercy Medical Center Contractor Bassett Mechanical~L~';;3dJ2}17
DSiugle Family DDuplcx DMlllti-Family DRcntal I!JCommercial DlndustriaJ
Hospital
hmbcr of Fixtures:
,.,
Res, Sink
Lndry Standp
DlspOS:l1
Di$hwasher
Sump Pump
F.jcctor/(iri nd
W3lr:r Soliner
Local \\'aste
O.:n[. Oper. Shamp Sink
DipWcll flr!Wst Sink
Drink Fill C:ltch U:l~ln
W:liI.SI. W~~h FIll
Ice CheM Urin.,!
cltam Sink (jar Dr.lin
ScuJr}' SUlk So<la Oi $P
lbnd Sink Coffee Maker
F Pn:p Sink Ice Maker
Scrv Sink Site Dr.un
Int Gr~se Trap Rouf [Jralll
Ext Gre:lse Trnp SloIndl' ReI."
R.P.Z. Valvc Eye W:lsh Stll
U:lthtub
\I,.'hirlpOI.)1
1.00V:llory
TOlkt
B:lr Sink
Water Healer
L G:l~J Elect 0 P....rVlll
Shower
nl'Or Dr.l1O
lndry Tr:lY
Lab Sink
Plaster Sink
Slerilizer
2
Clolhes Wshr
Didet
Beer TOIp
CJ:ls.>ml Sink
--r
Surgeons Sink
Breakl'lll Sink
Electric Con tractor
OR
DEJcctric Installation Verification form attached
(If Rc:placement)
Use I Nature of '''ork
Size
Material
Type
/I-
COM. Type
S:mitar}' Sewer
lJfm Sewer
----,r
Water Service
7/03