HomeMy WebLinkAbout0128317-Plumbing (abandon lateral)CITY OF OSHKOSH.
OS~-IKOSH PLUMBING PERMIT - APPLIC4TION AND RECORD
ON THE WATER
Job Address 2103 OREGON ST Owner CONVENIENCE STORE INVESTMENTS
Contractor RADTKE CONTRACTORS INC
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
No 128317
Create Date 01 /03/2008
Category 401 -Residential-Exterior (laterals) Plan
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest FlrlWst Sink
Lndry Tray Clothes Wshr _ Exam Sink ___ _ Catch Basin
Disposal Bidet Sculry Sink Wash Ftn
Dishwasher Beer Tap Hand Sink Urinal
Sump Pump Lab Sink Plaster Sink Standp Rec
Classrm Sink Sterilizer Surgeons Sink Ice Maker
Breakrm Sink Dip Well F Prep Sink Gar Drain
Ejector/Grind Drink Ftn Serv Sink Soda Disp
Date 01/03/2008
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 hol er .)and to secure any'~ecessary approvals before starting such activity.
Signature
Date ~~ ~ G~
Agent/Owner
Address 6408 CROSS RD WINNECONNE WI 54986 - 9731 Telephone Number (920) 582-4114
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
To schedule inspections please call the Inspection Request line at "LSti-5~~s noting the Aaaress, rermit Numper, type or
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.
$1,000.00 Plan Approval $0.00 Permit Fees $25.00 ^ Permit Voided
'Jun. 17. 2005 8:47AM inspection. services No. 1632 P. 1
City of Oshkosh
Inspection Services Divisiozt
P O Box 1130
Oshkosh, WI 549Q3-1130
Phone: (924) 236-5050
Fax: (920) 236-SOS4
P[umi,ing Permi# AppfiCa#ion
i~ ~~
(S!J THE Wtir1~R
I hereby apply for a pemut to do and install the following plumbing on the premises hereinafter descr'bed, the woxk to confonu to the
Wisconsin State Plumbing Code, in the performance of which all Parties hereto agree to and are bound by said stattttes.
• Application(s) and fee(s) can be brought to City HaII, Koom 205 or mailed to Inspection Services, l'O 13ox 1128,
Oslaicosh WI 549(}3-l 12A. Commencing work without permit(sj will result in fees being doubled ar $ I00.00 plus the
,normal permit fee, which ever is greater.
OR
you are p~ontrartar ngrt`i•eipating_.in th~_Permit Fee itccn'unt Svstem and.have adequate. funds,, check here
~. .:.
.~0~ Adtl['eSS ~ 6 d.l ~ M't°Qr~w1 Vdtl[IC (tpchtdinglabo~'andtr~tctials) ~ ~ °°G Date /^J '~~
:~
Owner ~~.~_~-----~--•_ Contractor ~~c~-.~ f.~ ~t~t~c.~'`o~ `
[~, Ingle Family QDnple~c {]Haiti-Family []Rental QCommercial]Industrial
Nutittber of Fixtures:
Bathneb
Whirlpool
Lavatory
Toilet
Rcs• Sink
Bar Sink
water licaar
U Gos E'J Uect ^ PwrVnt
Shower
Floor Drnin
Lndry Tray
Lab Sink
Plaster 5intc
Sterilizer
Misc.
FixtuCes
Flectrec Contractor
lliRpO$9I lhinlcl:fi Catch F3agin
thshwashcr Wait St wash rtn
Sump Pump ice Chest tJrins]
T~jector/(.triad Y.xarna Sink tsar chain
Water $nttncr Sculry Sink Soda l~~p
t.ocal Waatc Hand Sink Coffee Maker
(:lothes Wshr F Prep Sink tee Maker
F3idct Sexv Sink Site chain
tier •[•~ fit C.?~-easc'rrap hoof lhain
(.lascrm Sink Fiat txrcase'1 cap Standp Kcc
Surgcpne Sink R.P.7.. Valve Fiyc Wash titt3
>ircakml Sink Shan'p Sink Wtr Sewer Mtrs
Dip weft _ FIrJWst Sink Deduc[ Meters
Wtr Usage Mtrs
OR []Electric installation Verification form attached
(lf Replaeeaneni)
Use I l~atare of Work ,~~' cdnx_... _ ~~ C~a ~`-rr ~'_ _ _ _ ~s 41.~~ ~~ ~~ ~ ~ ~'`' ~•~-
Sint: Material Type ~ Conn. Type
Sanitary Sewer
Storm Sewer
Water Service