HomeMy WebLinkAbout0127992-Plumbing (backflow protection)
. CITY OF OSHKOSH No 127992
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 325 E NEW YORK AVE Owner NICOLET APARTMENTS II LLC Create Date 10/31/2007
Contractor JIM'S PLUMBING & HEATING INC
Category 420 - Residential-Other Plan
__.___..___".__._..__._... __...-.u____. ... _"'_~,__._.__ _______________._
Shower Water Softner Wait. St. Shamp Sink Coffee Maker
Floor Drain Local Waste Ice Chest FlrlWst Sink Int Grease Trap
Lndry Tray Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
Disposal Bidet Sculry Sink Wash Ftn RPZ Valve
Dishwasher Beer Tap Hand Sink Urinal Eye Wash Statn
Sump Pump Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Classrm Sink Sterilizer Surgeons Sink Ice Maker Deduct Meters
Breakrm Sink Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Ejector/Grind Drink Ftn Serv Sink Soda Disp
2 Boiler BF preventer
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature )nstatfbackflow protection-E serve water-supplies lo-boilers i-n-basemenI--n----------------------
of Work
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1003280000
Valuation _~_J.!2QQQ.OO Plan Approval ___~O.OQ Permit Fees ____ $25:2_Q D Pe~~it_Voided I
Issued By
Date 11/29/2007
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
GREENVILLE
WI 54942 - 9676 Telephone Number 920-757-5258
Address W6166 GREENVILLE DR
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.
111/29/2007 10:56 FAX 920 757 6482 JIM'S PLt~BING
ciN 0 v, 29, 2 I) 0 7 9 : 05 AM ins p e ct ion s e r vie e s
Inspection Servic~ Division
.? 0 Box 1130
Oshkosh, Wl $4903-1130
Phone:: (920) 236-5050
Fax.; (920) 236-$084
I4J 001/001
~O"~1
OfHKOIH
ON IHI: wA"fER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hl:TCirll;;\ner described, the work to confonn to the
Wisconsin State Plumbing Code, in the perforrnaMc ofwhkh all parties hereto agree to and are bound by s!\ld statUtes.
· Applic::nrion(s) and fee(s) can be brought to City Hall, Rcltlm 205 or mailed to Inspectton Services, PO 130x 1128, Oshkosh WI
5490J~1128, Commencing work withoutpermit(s) wirl result in fees being doubled Or $100.00 plus the normal permit fee, which
ever is greater,
O~
ell Account Svsfem and have a4!!,!lJatr! (unds t.'heck here
** Advisory.. For app1i(:able projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the: permit application. Applica.tions submitted without an EIV when such is required, will not be
processed for Permit: Issuance and will be returned fOT completion.
Job Address .? 21" {: Jp ( l) l. ~~ VaID. (L>,""'" ,.",," '=",",,"
~ Id jU(;.,. I .
Owner .~ UtnON. ~ f(J Xu u'J'" Contractor
~single Family ODupl x DMulti-Family
r9-
Date /I! #JilJ Q7
I
Number of Fixtures:
Dlndu!ltrisl
.$ f) 5. riV
f'lu~htllh
Whirlpeml
tavntory
Toiler
Res. Sink
!:3ar ~inl<
Water Healer
(j Gas 0 'EJc~t : PwrV nl
Show~r
floor Drain
Lndry Tray
Lab Sink
PI3.S1cr Sink
Srllrilizer
Misc.
E'b:rurc~
t)ir;p05Ill
Dishwa~hr:t'
Sump Pump
~eelorl(lrind
Wati:r Softn~r
Local Wnsle
CIQllle.~ W~hr
Bider
~<:i:r'l'~"
CIsssfTIl Sink
Surgeolls Sink.
Brcakml Sinl/
DipWel\
.HMe: Sibs
Drini( f"m
Wllir,St,
lee; Chest
Exam Sink
Sl:ulry Sink
lla.lIl1 Sink
F Prep Sink
Serv SinK
rot Grease Trap
U>r.t Gre:lsc Tr3P
R.P 2. Valve
Shamp S~
FlrlWsr Sillk
Carch Basin
Wash F'tn
Urinal
Gat DIm ill
Soc1a DJSp
Cotlec Maker
Comm, Ice Maker
Site Drain
RoofDraill
Standp Rec
Eye Wash Stn
Wu Sewer Mrrs
Deduct Meters
Wrr Usage Mm
Electric Contractor (for projects not requiring aD. EIV Form)
Use / Nature of Work 11(1le.i~N; J j),){,V'-{A+;:"~fl,)
I j __
Size MateriiAI Type
#
Conn. Type
S,mitary Sewer
SL.lrm Sewer
Water Servic~
07/0'/
11/29/2007 THU 10:41 [TX/RX NO 5685] I4JOOl