HomeMy WebLinkAbout2007-Plumbing (laterals)
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OSHKOSH
ON THE WATER
Job Address 3325 S WASHBURN ST
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner BERGSTROM OF THE FOX VALLEY INC
Contractor SCOTT DENOBLE & SONS SEWER & WATER INl Category 430 -Industrial-Exterior (laterals)
Bathtub Shower Water Softner Wait. St. Shamp Sink
Whirlpool Floor Drain Local Waste Ice Chest FlrlWst Sink
Lavatory Lndry Tray Clothes Wshr Exam Sink Catch Basin
Toilet Disposal Bidet Sculry Sink Wash Ftn
Res. Sink Dishwasher Beer Tap Hand Sink Urinal
Bar Sink Sump Pump Lab Sink Plaster Sink Standp Rec
Water Heater Classrm Sink Sterilizer Surgeons Sink Ice Maker
Site Drain Breakrm Sink Dip Well F Prep Sink Gar Drain
Roof Drain Ejector/Grind Drink Ftn Serv Sink Soda Disp
Misc.
Fixtures
No 127135
Create Date 10/05/2007
Plan ZZ2-275-1007-P
Coffee Maker
Int Grease Trap
5 Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
New auto dealership exterior laterals and site work per approved plan.
, ,
Size Material Type # Conn. Type
Sanitary Sewer 4" Plastic Lateral 1 New
Storm Sewer 4" Plastic Lateral 1 New
Water Service 1-1/2" Plastic Lateral 1 New
Parcelld #
Use/Nature
of Work
Valuation
$59,000.00 Plan Approval
$0.00 Permit Fees
$185.00 D Permit Voided I
Issued By
Date 10/05/2007
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 enf e easement restrictions of which it is not a party, if you perform the work
described in this pernz1,apPlication within aneas n;e~, the City strongly urges the permit applicant to contact the
easement holder(s) a tl to ecur any ne ~a ap rpvals before starting such activity.
I . '" j
Signature Date / tJ- ~ -c2oQ
Address 1910 VERLlN RD
GREEN BAY
WI 54311 - 0000 Telephone Number 920-469-2420, 920-4
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.
City of Oshkosh
Inspecition Services Division
P O,Box 1130
O~l:1kosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
~
OfHKOfH
ON THE WATER
Plumbing Permit Application
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-l128.Commencing work without permit(s) will result in fees being doubled or $100.00 plus the normal permit fee, which
ever is greater.
OR
Ij~ou are a contractor participating in the Permit Fee Account Svstem and have adequate funds, check here
i_ _ou want this lJrocessed throuzh 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
processed for Permit Issuance, "fd will be r~ed for completion.
Job Address ~ {j)ad~a alue (Inc1udinglaborandmaterials) Datelo.:.-oS- 02001
Owner bfpr6YY\ -SuJaAefL Contractor f:::,.;)toft (I&I~+ ~,
DSingle Family DDuplex DMulti-Family DRental DIndustrial
Number of Fixtures:
Bathtub Disposal Drink Ftn Catch Basin ~
Whirlpool Dishwasher Wait. St. Wash Ftn
Lavatory Sump Pump Ice Chest Urinal
Toilet Ejector/Grind Exam Sink Gar Drain
Res. Sink Water Softner Sculry Sink Soda Disp
Bar Sink Local Waste Hand Sink Coffee Maker
Water Heater Clothes Wshr F Prep Sink Comm. Ice Maker
o Gas 0 Elect [] PwrVnt Bidet Serv Sink Site Drain
Shower Beer Tap Int Grease Trap Roof Drain
Floor Drain Classrm Sink Ext Grease Trap Standp Rec
Lndry Tray Surgeons Sink R.p.z. Valve Eye Wash Stn
Lab Sink Breakrm Sink Shamp Sink Wtr Sewer Mtrs
Plaster Sink Dip Well F1rIWst Sink Deduct Meters
Sterilizer Hose Bibs Wtr Usage Mtrs
Misc.
Fixtures
Electric Contractor (for projects not requiring an EIV Form)
07/07
WARD: /d.ft.
s
LOCATION: .33,15 tJ~st,hl/rr1 6T
WORK DONE: J')14 Kl'_ J ~.. Te...o (11'\ I ~ .. ,nc..~ 1"'\
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INV#: QTY:
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PARTS:
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GRAVEL: !Jo
REMARKS: p~('rn'{t::lt J ;;Di.E I
ND ~~ G:;l5 '71
DATE: /11"'/.1-67
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DHL#:
TAP X
CUT -IN
SIZE: / 1.;2..
CONTRACTOR:
_<;'CcTr i)em:,.6lp ~
MEASUREMENTS:
/. S' Wa.(J W WC4shbur"
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/S~3' s~.t 5 Wt/l.vK.o.u
WORKERS: .<,& 1>5