HomeMy WebLinkAbout0123951-Plumbing (sewer)
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OSHKOSH
ON THE WATER
Job Address 403 N LARK ST
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner ERIKA REZENDES
Contractor MR ROOTER OF THE FOX VALLEY
Category 401 - Residential-Exterior (laterals)
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 new 4" sanitary sewer out to sidewalk and repipe drain stack in basement.
of Work
Size
Material
Plastic
#
Conn. Typ
Relay
Sanitary Sewer
4"
Type
Lateral
Storm Sewer
Water Service
Valuation
Plan Approval _~~_~().OO Permit Fees
$50.00 0 Permit Voided
Issued By
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the w rk
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature
Address PO BOX 3063
Agent/Owner
APPLETON
WI 54914 - 0000 Telephone Number 920-687-9178
No
123951
Ian
reate Date 03/21/2007
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Parcelld #
1609620000
Date 03/27/2007
Date
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Per it Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), y ur Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is r ceived. Work may
continue if the inspection is not performed within two business days from the time the project is rea y.
03/27/2007 08:15
9205879407
MR ROOTER
PAGE 01
:---
i
qty of Oshkosh
l.D$pcction Services Division
.p 0 Box. 1130
Oshkosh. WI 54903-.1130
:Phone: (920) 236-5050
Fax: (920) 236-5084
Plumbing Permit Application
I hereby apply for a permit to do and iDstaJl the :fiillowing plombiDg on the ptem/.se$ hcm:inafleJt tbcVo"Olk to ~m to the
Wiscousin State Plumbing Code. in the J?etfol:mance of which all parties hereto ~ to and arc . by said staCutcs.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection S . ces. PO Box 1128.
Oshkosh. WI 54903-1128. Commencing wax:k without permit(s) will result in fees being do led or $100.00 plus the
nomml pen:ni.t fee, wbich ever 1& greate(. . .
OR
.:rObAdmr~ tJ. lax-l~ ValDe_...;...._l
Owner Jh k ~ t'Y\ovY.l . Contracto~
~Single Family. . []Duplex. OMultl~Family . LlRental. DCo
_. ': , ., ~:d --::"-i~~~',.... ~ .
__ .. l.l..i,P.U. u;>>u....'!I-!'..,. -,.;..,
Number of Ftxnires:
~'~3':.~ ~"":'~'? F~ -:'~~r:;;:
Ba~.ib
Wt\iItpOot
Lavatot)'
T~let
Re:!o. Sinle
Bar- Sink
WIlh:r HC8Ult
o Gas 0 EIClCt 0 PwrVnt
Sbowr:r
DIcpoW .
Dlskwubc:r
Sump f't1nJp
~d
WK_ SafiDer
Local WlIltc
Clothes Wsbr
Bidet
Beer "hp
ctasnn Sink
Suraeoos SiDk
Brcak:nn Sink
Dip WqJJ
liOleBibs
DrfDk fin
Waft. St.
lee Chest
EXam Sink
Sculry Sink
BamI SiDk
F~ Snik
S<<v Sintr.:
lilt Grease b.p
Bxt Grease Tmp
1U'..z. Valve
Shimp Sink
FlrlWsl Smt:
.. Call:h BasIn
,Wash F1n
. UrInal
Oar Dr.ain
. Sack I>iBp
com. Mal<<lr
Comm. Jcn Mabl-
She Drain
RoofDreill
SUlIlIfp Rec
E)q: Wash Slit
wtrSawer MlI'S
Deduct Meters
Wtr Upgc Mtri
. .
-
Floor Drain
Lndry TraY.
Lab Sink
.l>Ill!It!:r Sink
Stl:riliEar
Mille.
fb:tums:
R.E.p~c.€.
Use I Nature of Work f2-E-
OR OEI~tlnstallation Ve cation form attached
n--". (If Rcphlcm1l::nt) .
L f\.:-rE."-""'l L D lrr~ I l) e 16 S J DE LJJ ft
AI\,) 4ie:: t2.Du. 6 HtJ V
Electric Contractor
Sanitary s~
Size
-4~'
Material
Type
#
Com. Type
StorrnSewcr
Water Service
..... 9 ,,'n-.;.