HomeMy WebLinkAbout0130138-Plumbing (laterals)OSHKOSH
ON THE WATER
Job Address 865 S WESTHAVEN DR
CITY OF OSHKOSH
No 130138
PLUMBING PERMIT -APPLICATION AND RECORD
Owner FISS 8~ BILLS POKLASNY FUNERAL HOME Create Date 05/23/2008
Contractor D.R. HANSEN PLBG.
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
Category 431 -Industrial-Exterior (other) Plan
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest Flr/Wst 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
Breaknn Sink Dip Well F Prep Sink Gar Drain
EjectorlGrind Drink Ftn Serv Sink Soda Disp
Date 05/23/2008
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 applipnt to contact the
easement holder(s) and to secure any necessary approvals before starling such activity.
Signature
Address 55 KNAPP ST
Agent/Owner
OSHKOSH
Coffee Maker
Int Grease Trap
7 Ext Grease Trap
RPZ Valve
Eye Wash Statn
_ Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Date
WI 54902 -3448 Telephone Number 233-1595
r o scneauie rnspectlons 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.
$20,000.00 Plan Approval $0.00 Permit Fees $99.00 ^ Permit Voided
05/23/2008 07:42 19202]337466
Ins~+eslion Services bivision
P 0 Box 1130
C)shkosh, R•'1 549U3-1130
1'honc; (S20) 236-SOSO
Flx:(920)ZiE-3084
;r:;t:•:~:~~ s;ri~~.::s
DR HANSEN PLUMBING
Plumbing Permit Application
PAGE 01
..~~: 4~;~P. I
r~r~w
I heret~v apply Eor a p~rnil a do rind ins:,ajl the following plunbing on the pram[scs hereinattar drscribod, tha work to conforn, to the
Wisconsin State Plumbing Code, i;- the performance o(which ali parties hereto ogee ro and are hoand by said stxnt[es.
• Applicnticn(s) and feels) can be brought to Cary Ha11, Room 20S or mailed m lnspoctioo Servtxs, p0 Sox 1 128, Oshkosh VI'!
54903-1 1:8, Gommcri~ing work without tern-i~si wil(re~u!t i, fees being doubled or SI00.00 plus the norrnflt pertnh fee, whirl;
eves is greater,
OR
rfy• _> r urs ~ ~~„r-ra~.~'.;'r,z,~rr'ci~p~(ttg ire rb¢ Pcrtnlr FEe Arco~nr Sy.ttem and hove ode~WOrs ~undc .ck~rf ir~rn
1~u'r.~ur! r~rr.v,pl ae~ r. t~ygli vorr~ cc~ nr
~''~ Advisory -For app~ieable plro~ects, an Etettxitcltl Installation Vt:rificadon ~rn fa>~, Signled by r1,eElectrical
Contractor or ~nmaowgCt (for ionstallationx allowed ro be petformt:dbrthe lzomcowncr) must be aabmittcd
with the permit applicatiol~. ~pfl{cations submitted without a>n EYV whrn such is rcgaued, will aot be
processed fbr Permit Issuance and wlll be returned for completion,
Job .~ddrC55 V,ilne (ittcludinp oboe a,a roarallls; ~ Datc~~~'~-F--O~'
O.rner K ~ . ~ (Contractor ~, j~. ~~u bt'
^Singilcf~amily it p(cx ^btulti•Family ^[tcatel '~ mmarcial f~Iaduarri~
Number of Fixtures:
9athtub ,CISpoS-~
(kink ern
"~h:r!pool D•anwnr9~a -.-._ µAlt.9r.
~~'°1°7' Sump Puctp _,,,` itt CMst
"'o'tIC: F;a-ror/fj;inG c'x~rn Jink
Res 5in~ Weir. 5ottner icalry51n6
BarSu'k La-ni Wasr: _..__ Harry Sint
lveter rester Ciotl;er W~hr F Prep Cink
Cs! ~ Elea ~ Pwr~'n;
Shower B:dct Sen• tick
Floor Dralq Bccr Tip -nr Cirr~re Trap
tri Tn -^~
~ y C:uswu $ilrk
E.'Et Grease 7np
LabSiek Sur2w•on! Sigk
-
rt_t'.z. Vshe
PlsslcrCipl; 9;t~me SIAk 531 Shtk
~
__ __
-
S ICnI22Et
~'a WeU
Fmwu SinK
.'Aisc.
Fivu:es _
Elertrir` Contractor (for projects >not ragairin
xn EIv E
g orm) r..~
I.ISe / Nantrc of VYork ~ ~r! S~-r m n? n ~
_ Cutcy 1tli i~ -
- Wuah Fm _
L:rimtl
_ _ Grr [kaia
~. S~Jw Di.e
Cu7~z 1,~aker
Comte. Tae M~Jrer
Sile (~tC
_. Ru~rl3rain
-- 51nnJp Ret:
FYe Wtorh Sin
WP Sewer MM
(ier7uer M;ten
V.ht lhcage ~4tre .. ._.
~~rarrn Sewer
i~',ttt,' Servioz
Size Meltrit~l
,~~`
corn. •rypa
o~. ~^