HomeMy WebLinkAbout0132853-Plumbing CITY OF OSHKOSH No 132853
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1326 CENTRAL ST Owner STEVEN G MARKECH Create Date 09/12/2008
Contractor HOMEOWNER Category 410 -Residential-Interior Plan
Bathtub 1 Shower Water Softner Wait. St. Shamp Sink Coffee Maker
Whirlpool Floor Drain Local Waste Ice Chest FlrlWst Sink Int GreaseTrap
Lavatory 2 Lndry Tray Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
Toitet 2 Disposal Bidet Sculry Sink Wash Ftn RPZ Valve
Res. Sink Dishwasher Beer Tap Hand Sink Urinal Eye Wash Statn
Bar Sink Sump Pump Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Water Heater Classrm Sink Sterilizer Surgeons Sink Ice Maker Deduct Meters
Site Drain Breakrm Sink Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Roof Drain Ejector/Grind Drink Ftn Serv Sink Soda Disp
Misc.
Fixtures
Use/Nature Remodel existing bathroom and add 1/2 bathroom
of Work
Size Material Type # Conn. Type
Storm Water
Valuation $1,500.00 Plan Approval
Issued By
Parcel Id #
1501220000
Date 09/12/2008
The undersigned, in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the
principle residence of the undersigned, hereby acknowledges, per Wisconsin State Statutes, ss 145.06, that other individuals
will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing
the work involved must be covered by a permit issued to a properly licensed Master Plumber.
In the performance of this work~yl agree to perform orl~.p~rsuant to rules governing the described construction.
Signature ~~ ,~/ ~ _ „~
Address 1326 CENTRAL ST
$0.00 Permit Fees $35.00 ^ Permit Voided
Agent/Owner
OSHKOSH WI 54901 3750 Telephone Number
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.
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.
Date ('-~Z~O~
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 H
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
I~you'are a contractor participatin,e in the Permit Fee Account System and have adequate funds, check here
if you want this processed through .amour account n
** 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 EN when such is required, will not be
processed for Permit Issuance and will be returned for completion. // p
Job Address 132 C~N~7LAC.. 5 ~ Value (Including labor and materials) (J`~bD~ ~ Date ('- f Zr-O~
Owner ~~vE /Ylt{2l<-~-~/ Contractor S~-F
Single Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial
Number of Fixtures:
Bathtub ~ Disposal Drink Ftn
Whirlpool Dishwasher Wait. St.
Lavatory Z Sump Pump Ice Chest
Toilet ~ 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 ~~ PwrVnt 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 projects not requiring an EIV Form)
Use /Nature of Work ~Z. ~tr`~EZ ~~STin~ ~ ~~ L 13,r~-r~-(, ~~ 1~ f-~~}LF 3<+~-/
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
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
o~/o~