HomeMy WebLinkAbout0131616-PlumbingOSHKOSH
ON THE WATER
Job Address 1921 OMRO RD
Contractor M P KELLY
CITY OF OSHKOSH No 131616
PLUMBING PERMIT -APPLICATION AND RECORD
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
UselNature
of Work
Valuation
Issued By
Owner WISCONSIN DEPARTMENT OF TRANSPORTA Create Date 07/15/2008
Category 430 -Industrial-Exterior (laterals) Plan
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest FlrlVllst 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
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Date 07/17/2008
In the pertormance 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 665 N MAIN ST
Agent/Owner
OSHKOSH
WI 54901 - 4431 Telephone Number 231-1750
i o scneauie mspectlons please call the Inspection Request tine 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 pertormed within two business days from the time the project is ready.
$~c 0~ Plan Approval $0.00 Permit Fees $25.00 ^ Permit Voided
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920)- 236-5084
• 3 ~+
JUL 17 2008 ~ `~
DEPARTME~~-1OF K H
COMMUNITY DEV`~!.~P P•1ENT ON 7HE WATER
INSPECTION SERVICES DIVISION
Plumbing. Permit App~ic~tion
I hereby apply for a permit to do and`install the following plumbing ontlie.premises hereinafter descritred, 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 Ha11, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-11.28.. Conunencingwork without permit(s)-will result in fees being doubled..or $100.00 plus the
normal permit fee, which ever is greater:
OR .•
If yvu are a contractor;participatn~ in the Per~nit~- .ee Aceount System and have adequate-,funds_.efr~7cr'itere ~t
i ou want this rocessed throw h. our ccount ~
05° ~ ~~,~,~~ //~~ r~' ~ ~rOf1 Date/5.~/' ~ y -
Job Addre$S ~'1't!lri"_ Value (Includingiaborand.niaterials):
Owner / :Contractor
Single Family ~l)uplexMulti-FaRlrxly []Rental ~Co ercalIndustrial .
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
O Gas 0 ElecC O PwrVnt
Shower
Floor Drain
Lndry Trap
Lab Sink
Plaster Sink
=~
Sterilizer ~,
Misc.. ~~
.Fixtures
Electric Contractor
Use /.Nature of
Disposal Drink Ffi
Dishwasher Wait. St.
Sump Pump >Ice Chest
Ejector/Grind Exam Sink
Water Sofiner ,Seulry-Sink
Local Waste ~Iarid`Sink
Clothes Wshr F Prep Sink
Bidet Serv Sink
Beer Tap Int<Grease Trap
Classrm Sink Ezt~:Giease Trtap
Surgeons.Sink R:P:Z. Valve
Breakrm Sink Shamp':Sink
'Dip Well )c)r/Wst.Sink
D+Educt Meters
Wtr Usage Mtrs
OR t ^Electric l(nstallaon'ue~ifnation f+~rm attached
(If Repiacetncgt)
Size. Material. , - Type # Conn.. Type
Sanitary Sewer
Storm:Sevwer ~ ~~ .
Water Service
Catch Basin
Wash Fm
Urinal
Gar Drain
Soda Disp
CoffeeMaker
Ice Maker
Site Drain
:Roof Drain
Standp Rec
Eye Wash Sm
Wtr Sewer Mfrs
9~ as-~v
a/os