HomeMy WebLinkAbout0124135-Plumbing (2 lavs)
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OSHKOSH
ON THE WATER
Job Address 145 W 24TH AVE
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner BETHANY UN CHURCH OF CHRIST
Contractor D.R. HANSEN PLBG.
Category 440 - Industrial-Interior
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature COMM / Replace 2 lavatories. **DEBIT ACCT**.
of Work
Shower
Floor Drain
2 Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Water Softner Wait. St. Shamp Sink
Local Waste Ice Chest FlrlWst Sink
Clothes Wshr Exam Sink Catch Basin
Bidet Sculry Sink Wash Ftn
d..'_' . '.p..
Beer Tap Hand Sink Urinal
Lab Sink Plaster Sink Standp Rec
Sterilizer Surgeons Sink Ice Maker
Dip Well F Prep Sink Gar Drain
Drink Ftn Serv Sink Soda Disp
No
124135
Create Date 04/09/2007
Plan
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
#
Conn. Type
Valuation
Issued By
Parcelld #
1411450000
$2,000.00 Plan Approval
~
$0.00 Permit Fees
$25.00 0 Permit Voided I
Date 04/09/2007
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 (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.
~04/0'3/2007 11:02 1'3202337466
*.-----
City of Oshkosh .
Inspection Services Division
POBox. 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
DR HANSEN PLUMBING
PAGE 01
(t)
OJ~OJR
ON TH W^TtR
Plumbing Permit Application
1 hereby apply for a permit to do and install the following plumbing on the premises hereinafter described. the work to confOtm to the
Wisconsin State Plumbing Code, in the perl"orroance of which all parties hereto agree to and are bourtd 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 W1 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
nds check here
Job Address /'1 S I.-v 2 <I -r-#- V alne (~"'d~...... ""..,,,,...;2.t> (> ~-', -, - , 'Date~
Owner IS E:"T \-\ <'\ "" ( C l;v ..cf4-..contractor D..i' - /-1.(>., lJ I<,. 'if, ~ I -
DSingle Family ODuv1e): OMuIa-Family DRental OComm~r.cial.: 'Dllidustri~l
Number of Fixtures:
',' ,'.
. '.,:
. ~"~' . ". ~ .. \ . .~
l3a thl\lb
Whirlpool
LAvatory
loilel
2-
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Local Wl&te
Clothes W~hr
Bidc:t
aeer Tap
Classrrn Sink
Surgeons Sink
Brc:alom Sink
Dip Well
HC)se Bibs
Drink Ftn
Wait. Sl.
lee Ctlesl
E:xam Sink
Sculry Sink
Hand Sink
F Prep Sink
Serv Sink
Int Grease Trap
S.XI Grease TllIp
R.P,Z, Valve
Shamp Sink
Flr/Wst Sink
Catch Basin
. WBSh Frn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Cornrtl. Ice Maker
Site Drnin
Roof Drs;n
Standp Reo
Eye W;l.sh Stn
Wtr Sewer MtrS
Deduct Meters
Res. Sink
Bar Sink
Wate:r Healer
o Gas 0 Elect 0 J>wrVnt
Shower
floor Drain
Lndry Tray
Lab Sink
Plaster Sinl<:
Sterilizer
Misc.
Fi X lures
Wtr Usage Mtrs
~.
Electric Contractor
OR
OElectric Installation Verification form attached
(If Replacement)
Size
Material
Type
#
Conn. Type
.\\0.\01 ~
~ u; I '!J ,r..fJ
\ \}f'
Use / Nature of Work
Sanitary Sewer
Storm Sewer
Water Service
ll/O!