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OSHKOSH
ON THE WATER
Job Address 400 S KOELLER ST
CITY OF OSHKOSH
No
126846
PLUMBING PERMIT - APPLICATION AND RECORD
Owner GROWTH MOTELS OSHKOSH/L D ENGELMAN Create Date 09/18/2007
Contractor JT SCHMIDT PLUMBING INC Category 440 - Industrial-Interior Plan ZZ2-271-0907-P
Bathtub 74 Shower 6 Water Softner Wait. St. Shamp Sink Coffee Maker 2
- -
Whirlpool 6 Floor Drain 22 Local Waste Ice Chest FlrlWst Sink Int Grease Trap 1
Lavatory 86 Lndry Tray 2 Clothes Wshr 4 Exam Sink Catch Basin Ext Grease Trap
Toilet 85 Disposal Bidet Sculry Sink Wash Ftn RPZ Valve 1
-
Res. Sink Dishwasher 8 Beer Tap Hand Sink Urinal Eye Wash Statn 2
Bar Sink 11 Sump Pump 2 Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Water Heater Classrm Sink Sterilizer Surgeons Sink Ice Maker 4 Deduct Meters
Site Drain 8 Breakrm Sink Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
-
Roof Drain 7 Ejector/Grind Drink Ftn 4 Serv Sink Soda Disp
-
Misc. 9 HOSE BIBBS
Fixtures
Use/Nature
of Work
INTERIOR PLUMBING FOR NEW MOTEL. CK#6534
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0611630100
Valuation
$272,900.00 Plan Approval
$0.00 Permit Fees
$2,450.00 0 Permit Voided I
Issued By
Date 09/19/2007
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
Address 419 S WASHINGTON ST
Agent/Owner
COMBINED LOCK~ WI 54113 - 1049 Telephone Number (920) 788-7314
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.
Permit App Plumbing
~.";
City of Oshkosh
InspectioQ Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
Page 1 of2
R
c
IV D
SEP 1 3 2007
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
Plumbing Permit AlWlication
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 withoutpennit(s) will result in fees being doubled or $100.00
plus the nonnal permit fee, which ever is greater.
OR
If you are a contractor participatinq in the Permit Fee Account System and have
adequate funds, type X;;:;$; if you want this processed throuqh your account' t""J '
Job
Address
Owner
Use Category:
C Single Family
o Industrial
o Duplex
Number of Fixtures:
Bathtub
Whirlpool I.",,~, ..,J
Lavatory LBk~J
Toilet L~5^,j
Res. Sink
tel
,,I
Bar Sink ["LL".J
Water Heater L,.__^",J
C Gas 0 Electric
@ PwrVnt
Shower t,_w,_b".,J
. " Floor Drain L~2--~..J
Laundry'Tray L2..."j
Lab Sink L_~.^,..,"J
o Multi-Family
Disposal I J
Dishwasher 1/31
Suinp Pump
Ejector/Grind I J
so~~~~ L.-l".^"l
Local Waste 1
Clothes Wshr t 'i, 1
Bidet L,.___.,J
Beer Tap L..__.",.,.J
Classrm Sink L~,,_..,.,J
Surgeons Sink
Value
(Including labor
and materials)
Contractor l
...;:I.,T,.
Dat~Cf.~lh(?? ,. J
....,.s.c;bJntiif,Pbt1B..,
~cl
0~
~ Commercial
{;J
Catch Basin 1....
Wash Ftn 1...,......,....,.1
Urinal L,.l,._J
Gar Drain to'. .",..,,;
Soda Disp
Coffee Maker L..~,...
Com:~~:: t ......z:;.. ...
Site Drain
o Rental
Drink Fm 1.'7'...
Wait. St. I. , .,
Ice Chest L,_.__.,...J
Exam Sink Lw........!
Sculry Sink I,..^':~..~.",J
Hand Sink L..I....:
F Prep Sink L ./
Serv Sink L..._..m...J
Int G~~~e L.2--,;
Ext Gr;:~ L",._..-..!
R.P.Z. Valve 1./....'
Roof Drain L,~.m..J
Standp Rec
Eye Wash Stn L :;...
http://www.cLoshkosh.wi.us/community _ development/inspections/permit_ app _plumbing_2... 7/8/2007
"'" Permit App Plumbing
Page 2 of2
Wtr Sewer
Mtrs
Deduct
Meters
Wtr Usage
Mtrs
Plaster Sink I...... ...... ....1 Breakrm Sink
Sterilizer L Dip Well t
Shamp Sink L .... .
FlrlWst Sink I. .w,,' .
Hose Bibs
Misc. Fixtures t."... ..."..1
I... .
^._.w'mm~^")
:;;5D
fT~d )( 7.00 = J~q~.c>o
Electric Contractor
L............,.......................~..".....
Permits requiring an Electric Installation Verification form can not be processed bye-mail since both
the application and EIV form must be submitted together. You may print these forms and submit them
together by coming to our office, mailing them or faxing them together at 236-5084.
Use / Nature ofWor
Size Material Type # Conn. Type
Sanitary Sewer L&.".II. . .n. . .. 11 ! I
Storm Sewer L....}ll~..........w..J L..............] L..................m.......w...! I.......". .J I..................... .w..
Water Service L...w..........,,_.........J L"..............m.................... L~...~._..w....."..,_.J L..m..........."...............m.<
http://vvww.ci.oshkosh. wi. us/community _ development/inspections/permit_ app _plumbing_ 2... 7/8/2007