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OSHKOSH
ON THE WATER
Job Address 500-550 S KOELLER ST
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
No 126945
Contractor BENO PLUMBING
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Lab Sink
Sterilizer
Dip Well
Drink Ftn
Owner RIVER VALLEY ONE LLC
Create Date 09/25/2007
Category 440 - Industrial-Interior
Plan ZZ2-272-0907-P
Wait. St.
Ice Chest
Exam Sink
Sculry Sink
Hand Sink
Plaster Sink
Surgeons Sink
F Prep Sink
Serv Sink
Shamp Sink
FlrlWst Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
4 Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
REMODLE TENNANT SPACE (540) FOR "SPORTS CLIPS" SALON.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
0611620000
Valuation
Issued By
$7,000.00 Plan Approval
$0.00 Permit Fees
$77.00 D Permit Voided I
Date 09/25/2007
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 PO BOX 8025
GREEN BAY
WI 54308 - 8025 Telephone Number 920-468-4777
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.
r'
City of Oshkosh t? R
Inspection Services Division 1^C\ '-\
POBox 1130 .P r J-. \/I
Oshkosh, WI 54903-1130 ~
Phone: (920) 236-5050 DEPARTrviENT OF
Fax: (920) 236-5084 ? COMMUNITY DEVELOPMENT
INSPECTIQN SERVICES DIVISION
Plumbing Permit Application
I
D
SEP 1 3 2007
~
OfHKOfH
ON THE WATER
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 without permit(s) will result in fees being doubled or $100.00 plus the normal permit fee, which
ever is greater.
OR
If vou are a contractor participating in the Permit Fee Account Svstem and have adequate funds. check here
if vou want this processed through vour account n
** Advisory - For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
;Qafessed for rmit Issuance and will be returned for completion.
~ Address . 5' J< OELLE~ alue (Including labor and materials) ~ 0 u.o I ~ Date q - 1-;2. --0 7
Owner S 0:'6 6<. ., c (...:r: p .s Contractor BEN 0 'P t- L.t M 13 r N G
DSingle Family DDuplex DMulti-Family DRental ~mmercial Dlndustrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater ~
XGas 0 Elect ~rVnt
Shower
Floor Drain -L
Sterilizer
Misc.
Fixtures
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrm Sink
Surgeons Sink
Breakrm Sink
Dip Well
Hose Bibs
-1-
---L
J
Drink Ftn
Wait.St.
Ice Chest
Exam Sink
Sculry Sink
Hand Sink
F Prep Sink
Serv Sink
Int Grease Trap
Ext Grease Trap
R.P.Z. Valve
Shamp Sink
Flr/Wst Sink
4-
-L
~
Lndry Tray
Lab Sink
Plaster Sink
Catch Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Comm. Ice Maker
Site Drain
Roof Drain
Standp Rec
Eye Wash Stn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
T o,t) L
) }-
Electric Contractor (for projects not requiring an EIV Form)
Use/Nature of Work Ti:rvA-NT BL.{:+l-o O{..(./ ,oF l3>e.l4t-t.rY ~14 LonJ
Size
#
Conn. Type
Material
Type
Sanitary Sewer
Storm Sewer
Water Service
~
A""Gr^-' )101 J.)'
rJ . a' I vr<..
L' ('\. ( If/'.. ~ 07/07
~ r
~
OJHKOfH
City of Oshkosh
Inspection Services Division
215 Church Avenue
PO Box 1130
Oshkosh WI 54903-1130
ON THE WATER
Fax
To:
Paul Wolf
Beno Plumbing
From:
(920) 236-5052
pwolf@cLoshkosh.wi.us
Office Hours 7:30 to 8:30 and 12:30 to 1 :30
Fax:
920-468-4729
Pages: 2
Phone:
Date:
09-13-2007
Re: Permit application for 540 S Koeller St cc:
o Urgent
o For Review
o Please Comment x Please Reply
o Please Recycle
A plan review is required to be submitted to our office before a permit can be issued for this project. The
fixture count under construction for that building currently exceeds 15. Per COMM 82.20 a plan review
is required for new installations exceeding 15 fixtures in a building. I will be out of the office on Friday
the 14th, You may contact Rich Wood if needed at 920-236-5049 on Friday.
Please contact me with any questions at the above phone number or e-mail address.
Thank You,
Paul T Wolf