HomeMy WebLinkAbout0132527-Plumbing (storm lateral)CITY OF OSHKOSH No 132527
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1545 ARBORETUM DR Owner ASSOCIATION RIVER MILL CONDO Create Date 08/27/2008
Contractor BOWERS, ROGER EXCAVATING Category 430 -Industrial-Exterior (laterals) Plan
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
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
Breakrm Sink Dip Well F Prep Sink Gar Drain
Ejector/Grind Drink Ftn Serv Sink Soda Disp
Valuation $4,000.00 Plan Approval $0.00 Permit Fees
Issued By
Date 08/27/2008
In the performance of this work, t 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) to secur ny ecessary approvals before starting such activity. p ~j ~j
Signature ~~~~~~'~/f ~y _4 _ Date 4 ~ ~ (/ A
.~
Address P O BOX 346
Agent/Owner
KAUKAUNA
WI 54130 - 0000 Telephone Number 920-766-3210
a~nnuu~e mspeciwns pease can me 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.
Coffee Maker
Int Grease Trap
1 Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
$57.00 ^ Permit Voided
FROM
Ciry of Oshkosh
Cnspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
(WE~)A110 27 2006 9: 66/57
~T Rao~6 u _ 479s
Nt ~ tw ~ ,Lan d r c a~t r.r ~ c ,
Plumbing Permit Application
9:64/No. 7600000929 P 3
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 Halt, 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 X100.00 plus the normal permit fee, which
ever is greater.
OR
If you are a contractor narticinatinp in the Permit Fee Acc2unt System and have adequate funds. check here
if you want this processed through your account
** Advisory -For applicable projects, an Electrical Installation Verification (EIV) 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 regained, will not be
processed for Permit Issuance and will be returned for completion.
Job Address ~ ~ 4 S A r (D J r t ~y ~~n O r . Value (Including labor and tnaterials) tf o ov nDa~te 8 ~-s /o $
Owner R~u~r H. tls Gond~.r,~n~o.ns Contractor _ Ol.)~.)CX~S ~.1JIrl~~~
^Single Family ^Duplex QMulti-Family ^Renta ~Cominercial Dindustrial
Number of Fixtures:
~
C
Bathtub Disposal Drink Ftn atch Basin
Whirlpool Dishwasher Wait. St. Wash Ftn
Lavatory Sump Pump Ice Chest Urinal
Toilet Ejector/Grind Exam Sink Gaz Drain
Res. Sink Water Sooner Sculry Sink Sada Disp
Bar Sink Local Waste Hand Sink Coffee Maker
Water Heater Clothes Wshr F Prep Sink Cotnm. Ice Maker
0 Gas C.I Elect ~~ PwrVnt Bidet Serv Sink Site Drain
Shower Beer Tap Int Grease Trap Roof Drain
Floor Drain Classrm Sink Ext Grease Trap Staodp Rec
Lndry Tray Surgeons Sink R.P.Z. Valve Eye Wash Stn
Lab Sink greak,tn Sink Shaznp Sink Wtr Sewer Mtrs
Plaster Sink Dip Well F1dWst Sink Deduct Meters
Sterilizer Hose Bibs Wtr Usage Mtrs
Misc.
Fixtures
Electric Contractor (for projects not requiring an EIV Form) N A
Use /Nature of Work yaca• d ra „~. ~ cn n c c,'rt S.. fv s f v~rn seuve~
Size Material Type # Conn. Type
Sanitary Sewer ~
~~
Storm Sewer /x'~ Wr, c _ ~~, ~ ~/,PG'~
Water Service
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