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Home My WebLink About0123788-Plumbing (installation) e OSHKOSH ON THE WATER Job Address 191 W 28TH AVE CITY OF OSHKOSH No PLUMBING PERMIT - APPLICATION AND RECORD Shower Floor Drain Lndry Tray Disposal Dishwasher Sump Pump Classrm Sink Breakrm Sink Ejector/Grind Owner HYDRITE CHEMICAL CO Create Date Category 440 - Industrial-Interior Plan Water Softner Wait. St. Shamp Sink Coffee Maker Local Waste Ice Chest Flr/Wst Sink Int Grease Trap Clothes Wshr Exam Sink Catch Basin Ext Grease Trap Bidet Sculry Sink Wash Ftn RPZ Valve 2 Eye Wash Statn - Beer Tap Hand Sink Urinal 2 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 JT SCHMIDT PLUMBING INC Bathtub Whirlpool Lavatory Toilet Res. Sink Bar Sink Water Heater Site Drain Roof Drain Misc. Fixtures Use/Nature Correction for installation of two emergency eye wash stations and relocation of one RPZ valve and installation of one new RPZ valve. of Work Valuation Issued By Size # Conn. Type Material Type Sanitary Sewer Storm Sewer Water Service Parcelld # 1413300000 $5,700.00 Plan Approval $0.00 Permit Fees $28.00 0 Permit Voided I Date 03/13/2007 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 hold d secure a approvals before starting such activity. Signature Date IS ~V'~P"t1) , Agent/Owner COMBINED LOC WI 54113 - 0000 Telephone Number 788-7314 Address 419 S WASHINGTON ST 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. Nov U~ U4 07:55a Oshkosh Inspections 920-236-5084 p. 1 City of Oshkosh Inspection Services Division POBox 1130 Oshkosh, WI54903-1130 Phone: (920) 236-5050 Fax: (920) 236-5084 ~ OJHKOJH ON THF WATFR Plumbing Permit Application I hereby apply for a pencit to do and install the follo'wing plumbing on the premises hereinafter described, the work to conform to the Wisconsin State Plumbing COde, in the perfonnance 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 I 'ou are a contractor artici aUn in the Permit Fee Account S stem and have ade '(you want this vrocessed through your account n Job Address Iq ( W ,J-gtt\~ Owner ~~~ Contractor DSingle Family DDuplex DMulti-Family $ ~ Value (IncIuding labor and materials) ~ ?VO J.l, S~ p~ DRental DCommercial Date 3-1'?~07 Ji :2:J?JUS- ~Industrial Nnmber of Fixtures: Bathtub Whirlpool L:<vatory Toilet Res. Sink BarSi...!.. Water Heater C Gas G Elect:J Pv.TVnt Shower Floor Drain I...ndry Tray Lab Sink Plaster Sin k Sterilizer Lndry Standp Disposal Dishwash('T Sump Pump Ejector/Grind Dent.Oper. Shamp Sink Dip Well F1r/Wst Sink Drink Ftn Catcl1 Basin Wait. St. Wash Fro Ice Chest Urinal Ex:>..') iil11k Gar Drain. Scul')' Sink So<laDisp Hand Sink Coffee Maker F Prep Sink Ice Maker Scrv Sink Site Drain lnt Grease Trap Roof Drain Ext Grease Trap I Standp Ree J{ R.P.Z. Valve Eye Wash SIn "'ater Sonner Local Waste Clothes W shr- Bidet Beer Tap Classrm Sink Surgeons Sink Breakrrn Sink Electric Contractor OR DElectric Installation Verification form attached (If Rep[acernent) Use I Nature ofWorl; I &.mtary Sewer Si' .' :\1atc)':.:.i Type " # - (""1m. Type I j Storm Sewer Water Service 7/03 .. j commerce.wi.gov ~i!!agJJ!m~!:! Safety and Buildings PO BOX 7162 , MADISON WI 53707-7162 TOD #: (608) 264-8777 www.commerce.wLgov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary March 05, 2007 CUST ID No. 605410 , RON PAULICK HYDRITE CHEMICAL CO 191W 28TH AVE OSHKOSH WI 54901 CROSS CONNECTION CONTROL ASSEMBLY REGISTRATION RICHARD A BIESE JT SCHMIDT PLUMBING INC 419 S WASHINGTON ST COMBINED LOCKS WI 54113 SITE: Hydrite Chemical Co ' 191 W 28TH Ave City of Oshkosh, 54901 FOR: Object Type: Cross Connection Control Device Regulated Object ID No.: 1120500 Device is Serving: CHEMICAL MIXING VAT; Device Type: Reduced Pressure Preventer; Location on Property: SE VAT MIXING RM ON SOUTH WALL; Manufacturer: WATTS; Model: 009M2QT; Serial No.: A05702; 2" Valve Size " '; ,. '" ." '," '. ':' ," '....... ,>.- ,- ...,::..,.... ;,"", .... "" :' ,.:";-," . Per yourrequa$t thedelJibe{s) described above has been REGIST;ERE[)wjt~,ouragency,in!leuQf, plp,~", review byo~ragency.As owrierofthis:buildingjYou should understand,: ' 'q' '<",' , . . '.' " l~' .. :,. t." '., ':" . '. ' , . . ," . . . , 1. That there will be no review of theinstallationplarisfor this project conducted by-the/Departmentof Commerce. 2. That there will be no routine inspections conducted by the Department of Commerce during the installation of this project. 3. That plan review and/or inspections by the loca.l municipality may be required by local permitting ordinances. 4. That this registration does not affect the requirements to submit plans for building systems, plumbing systems, private sewage systems, swimming pools, elevators or other plans if applicable. 5. That upon completion of construction, this installp,tion shall be in compliance with all applicable Wisconsin codes and standards. ,6. That as the owner, you are responsible to assure that a performance test is conducted for the above assemblies at the time of installation, immediately after repairs oralteration to the assembly and at least annually., , 8. "No person may engage in or work at plumbing in the state unless licensed to do so by the department per s.145.06stats. ' , , Prior to the start of construction, all applicable plumbing permits should be obtained from' the authorities having jurisdiction in accordance with local laws and ordinances. This registration is valid for the periOd RON PAULICK Page 2 3/512007 indicated above. Thereafter, the unfinished portions of the project shall be redesignedto the code existing at that time and shall be re-registered with our agency. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Please refer to the Transaction 10 No. referred to in the regarding line when making an inquiry or submitting additional information. Sincerely; Fee Required $ Fee Received $ Balance Due $ 125.00 125.00 0.00 /".. 'j (' ( p ....' '-Z'" '. 0/ },I ~'""'1/> ' .. - _~./ " . .... , "" . t ,--_//J I .~~.,-- ><;;1/ .,.(. ''''');''', \:'. .; .. ,. .' .: ,.,. . . Ch . t" S \ ~..~ ..,..c. (....L.t- '--.. rlS Ine everson '." Program Assistant, Integrated Services (608)267-2497 , 7:30 To 16:00 christine.severson@wisconsin.gov .11.llll.IlI[~I~ cc: Mqnicipal Clerk City of Oshkosh, 920/236-5011 .",-- ---',"-"', ~~- ,.-----.- ..~----- -~_.._,.._.-,,--_..-.-~. ---_.._-,._~-----..---,...~---.,...~_._-..~-_..._--.__.__.-. '---.'--.,- ~-,.- -.----- -"'''.. '-'" .,..~~._.- ~- .--"-"'-'"