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OSHKOSH
ON THE WATER
Job Address 191 W 28TH AVE Owner HYDRITE CHEMICAL CO
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
No
127930
Contractor JT~CHMIDT PLUMBINGING.________ _H_ Category ~~I.L::!r19~~trl~l.=In~IjE'"___
IIND / Interior remodel, install 2 acid dilution ba-sTrlS,"Tab sinks and sanitary pits. CHEMICAL WASTE SYSTEM DESIGN-SHALL BE
ISUBMIITED TO THE DEPARTMENT FOR REVIEW PER COMM 82.20.
I
I
I
I
I
l
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Shower Water Softner Wail. Sl.
Floor Drain Local Waste Ice Chest
Lndry Tray Clothes Wshr Exam Sink
Disposal Bidet Sculry Sink
Dishwasher Beer Tap Hand Sink
Sump Pump Lab Sink 2 Plaster Sink
Classrm Sink Sterilizer Surgeons Sink
Breakrm Sink Dip Well F Prep Sink
EjectorfGrind 3 Drink Ftn Serv Sink
Shamp Sink
FlrfWst Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
Create Date 11/16/2007
Plan
Coffee Maker
Int Grease Trap
2 Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
i
1
1
i
__I
Size
Material
Sanitary Sewer
Storm Sewer
Water Service
Type
#
Conn. Type
,....,...",
Parcel Id #
1413300000
Issued By
Valuation ____ $13,600.00 Plan Approval _____~,QQ Permit Fees_~:2Q D-,=-~~~.!!_~?i_~!:dJ
Date 11/26/2007
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 LOCKtWI 54113 -1049 Telephone Number (9?0)}.8?-7314
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.
....!,
Permit App Plumbing
Page 1 of 2 ,IL
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City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
REC IVEO
NOV 1 6 2007
DEPART!V1ENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
Plumbing Permit Awlication
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 $100.00
plus the normal permit fee, which ever is greater.
OR
If you are a contractor participatinq in the Permit Fee. Account System and have
adequate funds, type XE..$. if you want this processed throuqh your account .1................1
......J (Includ~:I~~: ~.l~/..~Pf?~~J DateJ....JJ~lf=.f?'7 ..J
and materials)
Contractor .L~.J::~..~~t!.~ 1.t?~-:_.!.':::.~..~:_....".m___~_mJ
.. 9 ~ S~.:+1: c~ (:> )
'C / ; 4l:..'J ";). 0 II ~
o Rental 0 Commercial
Add::S~ L.J~J
\IV
,
....,.........................
J-~ ffi .~T1t..~.~.T
n 'C · .
Owner ._'j2:&lI~m.._H::E!':.'.I.f-A.~.....h_6..
{
:\'
. Use Category:
C Single Family
pndustrial
'0 :Duplex
o MuId-Family
l] @ '7 '1 (.( Cf, 0 ()
Number of Fixtures:
Bathtub 1......1
Whirlpool L............ .....J
Lavatory L..-J
Toilet L__._~~I
Res. Sink I
Ba~ Sink L.._____...1
Water Heater L_~
Disposal 1........,............1
Dishwasher 1.......:...:........1
~Pump L_J
. Ejector~ 1.........3..._..1
Water I
Softener
Local Waste 1....__---'
C Gas 0 Electric Clothes Wshr t. ... ......1
@ PwrVnt
Bidet I . I
"
'Shower I
. .' Fioor Drain J
Laundr}'Tray
Lab Sink I_..J
Beer Tap
Classrm Sink I. J
Surgeons Sink L.__........__J
..'?
Drink FtnL.....!
Wait. S1. 1....................1
Ice Chest I _
~~Sink L~.__.j
Sculry Sink I
. Hand Sink [..._..._.....!
F Prep Sink L.....
Serv Sink L I
Int Grease L . !
Trap . -----!
Ext Grease I
. Trap.
R.P.Z_ Valve L.......__J
fic.. (f:)
O!~~in t.;?.....!
Wash Ftn t....................!
Urinal L__I
Gar Drain L... _.....c.J
Soda Disp L___~J
Coffee Maker L__.._..__...1
Corom. Ice 1
Maker ..
Site Drain Ii.
RoofDraill I
StandpR:~c L---=J
Eye Wash Stn L.....___..J
http://www.ci.oshkosh.wi.us/community development/inspections/permit app plumbing 2... 7/8/2007