HomeMy WebLinkAbout0126542-Plumbing (restroom/sink)
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OSHKOSH
ON THE WATER
Job Address 1855 S KOELLER ST
,i
CITY OF OSHKOSH
No
126542
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner OSHKOSH LASALLE 93 Create Date 08/10/2007
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 BASSETT MECHANICAL
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature Medical Offices /Interior partition and casework alterations, add a Drug Screening Restroom in the lower level and install new hand sink in
of Work 1st floor exam room.
Valuation
Issued By
Size
#
Conn. Type
Material
Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1307440601
$0.00
Permit Fees
$25.00 D Permit Voided I
Date 08/30/2007
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 secu any n sary approvals before starting such activity.
Signature ~ Date 2V'~/ti7
.
Agent/Owner
KAUKAUNA
WI 54130 - 7000 Telephone Number 800-236-2502==920-
Address PO BOX 7000
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.
I J 1
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2J2 04
10:02a
Oshkosh Inspections
920-236-5084
p. 1
City of Oshkosh
. 'wecrion Services Division
('1)ox 1130
... ..J(osh. WI 54903-1130
Phone; (920) 236-5050
fOl.\; (910) 23G-508~
f
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OfHKOJ'H
or" r.....:: Vl",r~."
Plumbing Permit Application
I hereby apply for a pennit to do and install the following plumbing on the premises hereinafter described, the work to conform to the
\Visconsin State Plumbing Code. in the pcrfonnancc of which all parties hereto agree to and are bound by said statutes.
. Application(s) and fee(s) can be brought to Cily 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 S 1 00.00 plus the
noml:l1 permi~ fee, which ever is greater.
OR
Ifvou are a contractor r>l1l'ticipatin1! in the' Permit Fee Account Svstem and /rave adequate funds. check here
if \'0/1 want thi.~ J2IQr:e.sS.ed tlzLou,?/r VO/lr account n
Job Addr'ess
1855 S. Koeller Rd.
Value (Including l:lbor :lnd m:ltcri:lIs) 3200.00
Date 8/30/07
Owner Affinity
DSingle Family DOuplc):
Con tractor
0[\.'1 ulti- Fa mil)'
Bassett Mechanical
DRcntal
jggCommercial
Dlndustrial
r'nbcr of Fixtures:
TOlk!
1
Lndry Stanll;> lJ.:n!. Opcr. Sh:Jmp Sink
Disposal DipWe:ll flr!W:it Sink
O1:;hwashcr Drink Fill Catch l3a~in
Sump Pump '\":lit St Wa~h Fill
F.jcctor/(,rincl Ice Chest Unn.,l
Wal,:r Sottner E~am Sink 1 (jar Or.1;"
Local \\"aste Sculr}' SlIIk Soda Oi sp
Clolh.:s Wshr Hand Sink Coffee Maker
Did..:l F I'n:p Sink Ice Makcr
Beer Tap Scrv Sink Site Dr.un
CI:IS.iml Sink Int Grc.3:ic Trap Rouf [)ralll
Surtcons Sink E:tl Grease Trap Slandl' Rcc
Brc;lknn Sink R.PZ. Valve: Eye Wash SIn
Uathtub
'l,'hirlp<x))
Lavatory
Res. Sm:':
Bar Sink
Waler Heatcr
[ Ga:i .J Elect 0 P\\TVnt
Shower
F1~or IJr:lIO
lndry Tr:lY
L:lb Sink
Plaster Sink
Sterilizcr
-;:-
Electric Contractor
OR
DElcctric Installation Verification form attached
(If Rt:placcmcnt)
Use I Nature of "'ork
Size
M:J.t~ria]
Typt:
#-
Conn. Typ~
Sanitar>' Sewer
. r\n Sewer
\Vater Service
7/03