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Home My WebLink About0131976-Plumbing (2 bath remodel)/~ CITY OF OSHKOSH OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1125 GRAND ST Owner KEITH E/RHONDA R POND Contractor KELLY INSPECTION SERVICE LLC Category 410 -Residential-Interior Bathtub Whirlpool Lavatory Toilet Res. Sink Bar Sink Water Heater Site Drain Roof Drain Misc. Fixtures UselNature of Work Valuation Issued By 1 Shower 1 Water Softner Wait. St. _ Floor Drain Local Waste ice Chest 2 Lndry Tray Clothes Wshr ' Exam Sink 2 Disposal Bidet ' Sculry Sink Dishwasher Beer Tap Hand Sink Sump Pump Lab Sink ' Plaster Sink 1 Classrm Sink Sterilizer Surgeons Sink Breakrm Sink Dip Well ' F Prep Sink Ejector/Grind Drink Ftn ', Serv Sink Shamp Sink Flr/Wst Sink Catch Basin Wash Ftn Urinal Standp Rec Ice Maker Gar Drain Soda Disp No 131976 Create Date 08/01/2008 Plan Coffee Maker _ _ Int Grease Trap _ __ Ext Grease Trap RPZ Valve Eye Wash Statn Wtr Sewer Mtrs Deduct Meters _ Wtr Usage Mtrs Date 08/01/2008 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 holder(s) and to secure any n essary approvals before starting such activity. Signature ~i~-~.----~/'~~'G --Z" Date ~'~-~ a ~.., Agent/Owner Address 5097 SHERMAN RD OSHKOSH WI 54901 - 9755 Telephone Number (920) 284-1458 I o scneaule 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. r $~~~n Approval $0.00 Permit Fees $49.00 ^ Permit Voided City of Oshkosh Inspection Services Division P O Box 1130 Oshkosh, WI 54903-1130 Phone: (920) 236-5050 Fax: (920) 236-5084 Plumbing Permit Application 01HK0~ ON THE WATER I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, 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 Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the normal permit fee, which ever is greater. OR ~! If you are a contractor ap rticipating in the Permit Fee Account System and have adeguate funds check here if you want this processed through your account n ** Advisory -For applicable projects, an Electrical Installation Verification (EIS 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 submitted without an EIV when such is required, will not be processed for Permit Issuance and will be returned for completion. _ ~ Job Address ~~~~ ~~~~~ Value(Includinglaborandmaterials)/~~`) Date ~ / ~~ Owner ~~r~-l~ Contractor L~a~-1~ ~;'/ ~?.~ /l~" I"7 f' ~ 2 30~~/8 Single Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial Number of Fixtures: Bathtub ~ Disposal ' Drink Ftn Whirlpool Dishwasher ' Wait. St. Lavatory ~ Sump Pump j Ice Chest Toilet w Ejector/Grind ~ Exam Sink Res. Sink Water Softner Sculry Sink Bar Sink Local Waste ' Hand Sink Water Heater Clothes Wshr F Prep Sink ^ Gas ~ Elect rVnt Bidet Serv Sink Shower ~ ' Beer Tap Int Grease Trap Floor Drain Classrm Sink Ext Grease Trap Lndry Tray Surgeons Sink ' R.P.Z. Valve Lab Sink Breakrm Sink Shamp Sink Plaster Sink Dip Well ' Flr/Wst Sink Sterilizer Hose Bibs Misc. ~ Fixtures Electric Contractor for projjects not requiring an EIV Form Use /Nature of W~~ ~_~"~,1'~('~1M ~~-~~~ .I Catch Basin Wash Ftn Urinal Gar Drain Soda Disp Coffee Maker Comm. Ice Maker Site Drain Roof Drain Standp Rec Eye Wash Stn Wtr Sewer Mtrs Deduct Meters Wtr Usage Mtrs Size Material Type # Conn. Type Sanitary Sewer Storm Sewer ~ Water Service o~~o~