HomeMy WebLinkAbout0126234-Plumbing (relay)
. e CITY OF OSHKOSH
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1785-1787 MARICOPA DR
No
126234
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Gri nd
Owner GREEN TEE NORTH CONDOMINIUMS Create Date 08/13/2007
Category 430 - Industrial-Exterior (laterals) 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
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 D.R. 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
Relay water service to 1785 Maricopa
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service 1-1/2" Plastic Lateral 1 Relay
Parcel Id #
$2,000.00
$0.00
$50.00 0 Permit Voided I
Plan Approval
Permit Fees
Date 08/13/2007
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 holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
OSHKOSH
WI 54902 - 3448 Telephone Number 233-1595
Address 55 KNAPP 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.
!
08/}3/2007 08:35
19202337455
DR HANSEN PLUMBING
i
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PAGE 01
Cit:-' ,):'O;hkosh .
Inspcdol\ Scr,'ices Divisl<"n
p 0 BQA ; 130
Oshkosh, WI 54903-1130
l'hN12: (920) 236-5050
Fo.>: (920) 236-5084
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ON TKe W^TE~
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Plumbing Permit AppliQ tion
. !
, unds: check here
I b:'(;by apply for: a permit to do and install the following plumbing on the premises! reinafter described, the'work to conform 10 the
Wisco;1Sin State Plumbing Cod~, in the performance of which all'parties her~t agree toaild arc bound by said statutes,
· .'\pplicati ones) and fee(s) can be brought to City Hall, Room 205 or rnail~ to Inspection Services, PO Box 1128,
Oshkosh \VI 54903-1128. Commencing work without permit(s) will te t in fees being doubled or $100.00 plus the
n<)i'Im.l permit fee, which ever is greater.
OR
fJ...:'i.. ~;!".Q.!:.i:..!ls..Q.1!1Lac((Jr (IT i i tin J'n the er i't ee
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. j o~ Ad dre"_ I, ~ s-M 1\"'-1(. ;:'7Av 1ll1le (In''"''i~.,.b,;.1:S'
0'., 11 rf ~t:. E vJ -,-l(.€ c::. Contractor .
C1Sil1gle Family ,DDuplex ~ulti~FamilY . DRental
-cJln~ustria( ~'
N1lmber of Fixtllres;
I;~ ~~ ;';. ~,;':' :",? ~..~ .
. ,.\ .
Pl''''\;~':'
r' 3- :~i"k
Disposal
Dishwasher
Sump Pump
Bjec.tor/Grind
Wat~r Softner
Local Waste
Clothes Wsl\r
Bidet
Beer Tap
ClllSsrrn Sink '
Surgeons Sink
,Breakrm Sink
Dip Well
Hose Bibs
Drink Fin
rl:',.Ii~1 S;n~
Wait.Sl.
Ice Chesl
Exam Sink
Sculry Sil\k
Hand Sin\<
fi" Prep Sink
Serv Sink
Int Grease Tl'lIp !
EXI Grease Trap:
JU'.Z. Valve:
Shamp Sink
FlrlW~1 Sink
- ,:: It!' '
-.--
, Catch Basin
, Wash Fm
lJrinal
Oar PnIin ,
,Soda Disp
Coffee Maker
Comm. Ice Maker
Site Drain
Roo(Drain
S=dp Reo
,Eye WltSh Sin
Wrr Sewer M trs
Doouc.1 Meters
Wtr Usage Mtr;
\'.1' ""j:oc'l
(,:l','MC.;)'
1'o'ld
f.:e ;" .)'~~:
\'!,,:er ;;cztcr
\: (;:,.1:1 J2ko', 0 P"-"tV:\l
~h -'\\o'er
Fi( c: rir:li~
Ln jry Tr~y
I a"J i;;;lk
St!'ri!i,":'Cf
t.l ;.t..
I, i.'t\Jf~$
Electric Coutractor
o:n
DElect~ lnstallation Vedfication form attached
(If Rep,l emC1lt)
lisc / Nalure of WOl"k
r- - - ----.
S.Cl',ilai)' Sewer
Size
r'2:-
Material
Type
#
Conn. Type
S ,('tlTI Sewer
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