HomeMy WebLinkAbout0128014-Plumbing (sink)
G
OSHKOSH
ON THE WATER
Job Address 2211 OREGON ST
CITY OF OSHKOSH
No
128014
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner COYOTE OF WISCONSIN LLC Create Date 12/03/2007
Category 440 - Industrial-Interior Plan
Water Softner Wait. St. Shamp Sink Coffee Maker
Local Waste Ice Chest FlrlWst Sink Int Grease Trap
Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
Bidet Sculry Sink Wash Ftn RPZ Valve
Beer Tap Hand Sink Urinal Eye Wash Statn
Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Sterilizer Surgeons Sink Ice Maker Deduct Meters
Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Drink Ftn Serv Sink Soda Disp
Contractor LEE PLUMBING INC
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
Oshkosh Truck (Suite Y) /Install breakroom sink
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1410280000
$500.00 Plan Approval
$0.00 Permit Fees
$25.00 D Permit Voided I
Date 12/03/2007
In the performance of this work, I agree to perform all work pursuant to rules goveming 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
APPLETON
WI 54911 - 0000 Telephone Number 920-882-2215
Address 1316 N RICHMOND ST
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.
CiAug, 24. 2007 6:55AM
Inspection Services Division
POBox 1130
Oshkosh. VVI54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
inspection services
No. 4~. 2
~
OJHKOfH
ON THE WATliR
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter de1,\cribcd, lhe 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 VVI
54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 pluS the normal permit fcc, which
ever is greater.
OR
Jfvou are a contractOr participarin~ in the Permit Fee Account Svslem and have adequate funds. check here
if vou want 1hz's processed throu,?h vour accrJ.Ji.nt 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 su.bmitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
Job Addr.css~Jl\'t Ore "'A^' Sot. Value (InC1UdinglabOrandmBterials~ 5DO. '00 Date" /3'O/D]
Owner OSh~o.s."'l"rv..'--\<..... Contrat1:or Lee.. \ 5> Pl '"'-.......b"\ '" ~ . mP tt '>'d- 5 S 7 b
DSingle Family DDuplex DMulti-Family DRental ~Commercial' Dlndnstrial
Number of Fixtures:
Rathtllb Disposal Drink Ftll Catch Basin
Whirlpool Dishwasher WaitSt Wash fm
Lavatory SUl'llp Pump tee Chesl Urinal
Toilet Ejector/Grind Exam Sink Oar Dnlin
Res. Sin'- Water Softner Sr;ulry Sink Soda Disp
Bar Sink Local Waste Hand Sink CoffCQ Maleer
Water Heater Clothes Wshr F Prep SiJIk Comm. Ice: Maker
IJ Gas :J Elect iJ PwrVnt Bidet Scrv Sink Site: Imin
S/lowc:r Beer Tap lnt Grease Trap Roof lirain
Floor Drain Chusrm Sink Exl Grease Trap SUlndp Reo
LndlY Tray SurgeollS Sink R.P.Z. Valve Eye: Wash Sm
Lab Sink Bn:aknn Sink ...;b... Shlll1lP Sink Wtr Scwor Mtrs
Plaster Sink l)ipWell I'lr/Wst Sink Deduct Meters
Sterilizer Hose Bibs Wtr Usage Mtrs
Misc.
Fixtures
Electric Contractor (for projects not requ.iring an EN Form)
Use/Nature of Work '1V\..::>t""\\'1~5 OAe 5:1t"\ \<- )fel''''''",t- fee ;::'.s~';;)'oo
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
07/07