HomeMy WebLinkAbout0131893-PlumbingOSHKOSH
ON THE WATER
Job Address 1130 N WESTFIELD ST
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner EVERGREEN MANOR INC
Contractor J RASMUSSEN PLUMBING INC
Category 440 -Industrial-Interior
Bathtub Shower 1 Water Softner Wait. St.
Whirlpool Floor Drain 1 Local Waste Ice Chest
Lavatory 1 Lndry Tray Clothes Wshr ~~ Exam Sink
Toilet 1 Disposal 1 Bidet Sculry Sink
Res. Sink 1 Dishwasher Beer Tap ~ Hand Sink
Bar Sink Sump Pump Lab Sink Plaster Sink
Water Heater Classrm Sink Sterilizer I Surgeons Sink
Site Drain Breakrm Sink Dip Well F Prep Sink
Roof Drain Ejector/Grind Drink Ftn I Serv Sink
Misc.
Fixtures
Use/Nature Retirement Home /Unit MS1027 -Remodel bathroom to meet Type A Dwellin
of Work ',
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
Shamp Sink
Flr/V1Ist Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
accessibility.
# Conn. Type
No 131893
Create Date 07/01/2008
Plan
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Parcel Id #
1608640000
Valuation $4,000.00 Plan Approval $0.00 ~ Permit Fees
Issued By
Date 07/29/2008
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
Agent/Owner.
Address 1914 GREENBRIAR TRL OSHKOSH ', WI 54904 - 8887 Telephone Number 920-231-1289
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.
$42.00 ^ Permit Voided
07/29/2008 07:23
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, Wi 54903-1130
Phone: (920) 2i6-5050
Fax: (920) 23F.t-S0~$4
2336747
J RASMUSSEN
Plumbing Permit Application
PAGE 01/01
oN rHr< wntF
** Advicoxy - l4oz applicable projects, era Electrical Installation Ve>rr$. Icativ>ta (E~ form, signed by the Eleetx~.ical
Contractoz or Homeawner (for installations alle~oved to be lfe>rfolrmed by the ,homeowner} must be subnnitted
with the permit applicatiaa. Applications snbxnitted without aan E]lV when sack is required, will not be
processed far Permit Issnaace and ra<-lll be retnxtted foz dnnolDletaon.
o~
Job Address t~ 3u ~~ w ~Sr ~' ~ a Value (including latx+rand r-raterials) ~ ~~ .'r Date ~~~~~
Owner ~ ~cr~-y' ~fi`+~. Contractor ~, M SS EN ~ ~ . ~'G .
^Single Y:amily ^Dnplex ^ivlolti-Family QRental Commercial lndustrl~f
Nambcr of Fixtures:
Bat}riuh T)i8(~t-Fal i I Drink Fm • G'+tch 1';agin
Whirlpool AlSbwashcr Wait. St Wash FM
Lavnrory P Slnnp Rump ~.-, ~~ Ice Chtat• tJrinN
Toiler Eioctor/Grind Y,,,,,~_ I F..xam $ink iior prttin
Rey, pink _...~ _. WatcrSotEtcr ~ San-ry Sink SodaiJiap _,,,~.
gar Sink T ncpl Wa9te _~~,.~ ~~, Hand Sink GOf,Is6 MAkar
WaterHcater Clotho Wshr ', F Prep Sink Comm. lx Maker
IJ Gan I,I Elect 1_I PwrVnt
~
13idct '
' ScrvSink """""~
SireprAin
Shower
Fl
i
~ Aver Ta
p
_.. -ntQreeaoTrnp
.
.
Roofpmin
n
oor Arl Cla`erm Sink _
__
' Dct Greegc Trnp
.-~ Shlhdp Rex
~~ Tray """-~
5urgtons Sink
_ i
R.PZ. Valve Ayc Wsa11 gm !~.
Lnb Sink
.~ Brceknn Sink _ Shamp Sink Wtr Sewer Mtrs
Rlalter Sink Di W~li
P
_.___ Flr/Wg1$Ink
i]t:ductMctcrs
Stcrilixcr ^ ..^
~ ~
fTosc Tii6a _
~ Wtr Llsa{re M,rrs
Migc,
rixa~rea ~I
Electric Contractor (for project oat reciniriing arl EN' Form)
Use /Nature of Work ~00~ M ~ /0 ~-7 ~Q ~-..o~-~ ~-+~- ~r,~ A
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
water Service
o~io7
hCrIEF1V at)ttlV fitr A tterml}. t(t ('I() anl() /flCfAll r11P. 'Fi+IlAwtn~ »Illmhlnn nn tltP. ni'f?T1VPC ItP.rPtnA~PY ~IPOr:nlnPrl rhP wn*4 rn rnnFnrm fn ~hA
Wigconain State Plumbing CAde, in the performance of which all parties hereto agree to and are bound by Said statutos.
• Application(s) and fee(s) can be brought to Ciiy Hall, Room ?.OS or mailed to inspection Services, p0 Box i 12R, Oshkosh WI
54903-I l2$. Commencing wot•1c without permit(s) will result in fees being douhled or S] 00.00 plus the nol7tlaJ permit fee, which
ever is gr~eadsr.