HomeMy WebLinkAbout0123881-Plumbing (sink)
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OSHKOSH,
ON THE WATER
Job Address 215 CHURCH AVE
CITY OF OSHKOSH
No
123881
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/G rind
Owner CITY OF OSHKOSH Create Date 03/22/2007
Category 440 - Industrial-Interior 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 DR HANSEN PLBG.
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
Install new sink on 1st floor.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0701410000
$300.00 Plan Approval
$0.00
$0.00 D Permit Voided I
Permit Fees
Date 03/22/2007
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 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 (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.
City of Oshkosh
Inspection Sernces Division
POBox 1130
Oshkosh, m:r 54903-1130
Phone: (920) 236-5050
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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If vou are a contractor participatinf! in the Permit Fee Account System and have adequate funds. check here
if vou want this processed throuzh your account n
Job Address 2/.$" C Wi\.. " iJ Vah.le (In!:ludinglaborandmaterials)
Owner c...."t" V !:> F (0, kJt.k~ y.p,. Contractor .J:J -t~
DSingle Family DDuplex DMulti-Family DRental
3o~
W-A i4~e ~.
@...Commercial
Date
DIndustrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
-L
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrm Sink
DrinkFtn Catch Basin
Wait.S!. Wash Ftn
Ice Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink Cornm. 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
Water Heater
o Gas 0 Elect 0 PwrVnt
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
Fixtures
Surgeons Sink
Breakrm Sink
Dip Well
Hose Bibs
Electric Contractor
OR
DElectric Installation Verification fo'rm attached
(lfReplacement)
Use / Nature of Work
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
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