HomeMy WebLinkAbout0123726-Plumbing (backflow preventer)
~.
OSHKOSH
ON THE WATER
Job Address 1101 CEAPE AVE
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner MARK A/THERESE M BURAZIN
Contractor O'NEILL ENTERPRISES INC
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Category 410 - Residential-Interior
No 123726
Create Date 03/07/2007
Plan
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
~FR/ Install backflow preventer on boiler system. **DEBIT ACCT**.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
0805060000
Valuation
Issued By
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
BreakrmSink Dip Well F Prep Sink Gar Drain
Ejector/Grind Drink Ftn Serv Sink Soda Disp
vacuum breaker
$50.00 Plan Approval
~4
$25.00 D Permit Voided I
Date 03/07/2007
$0.00 Permit Fees
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
AgenUOwner
Address 522 W 6TH AVE
OSHKOSH
WI 54902 - 5916 Telephone Number 920-230-2007
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.
~3/07/~007 08,18 FAX
19202302008
ONEILL ENTERPRISES
I4J 0011001
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh,VVI54903-1130
Phone: (920)236.5050
Fax: (920) 236.5084
Plumbing Permit Application
I hereby apply for a pennit to do and install the following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plwnbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
. Application(s) and feees) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,'
Oshkosh WI 54903-1128. Commencing work without pennit(s) will result in fees being doubled or $100.00 plus the
nonnaJ permit fee, which ever .is greater. .
OR
are co r ct r artic' t'n in the Permi
'W nt this rocessed throu h our account
Job Address j I tJ J ~ell{JfJ~ Ii lfifb
Owner M/lr g~ J ere.ce.
~ingle Family DDuplex
, ~6 trO
Value (Including laborand materials) 0, I
Contractor OJ J..!.eii2
Date$7r D1
DMuIti-Family
DRental
DCommercial
Dlndustrial
Number of Fixtures:
Disposal Drillk Ftn Catch Basin
Dishwasher Wait. St. , Wash Ftn
Sump Pump Ice Chest Urinal
Ejector/Grind &am Sink Gar DraiD
Water Softner Scull)' Sfnk Soda Dlsp
Local Waste Hand Sink: Coffee Maker
Clothes Wshr F Prep Sink Comzn. loe Maker
Bidet SelV Sink Site Drain
Beer Tap , Int Grease Trap Roof Drain
Classrm Sink Ext Grease Trap Scandp Roc
Sur&cons Sink R.P.Z. Valve Eye Wash Sin
Br~ Sink Shamp Sink Wtr Sewer MtrlI
Dip Well Flr/WstSink DedactMeters
::~izer Ivacy;;J;i;;fU~(~ ~J WtrUsageMm
. ~::iC Contracto;~ -.. -Y?~!2l!:. DElectric Installation Verification form attached
(If Replacement)
Bathtub
Whirlpool
LavatOI)'
Toilet
Res. Sink
Bar Sink
Water Heater . _
o Gas 0 EJect 0 PwrVnt
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Use (Nature of Work
Material
Type
#
Conn. Type
"1?-lt
.~ \?--1:J
Size
Sanitaty Sewer'
Stann Sewer
Water Service
11105