HomeMy WebLinkAbout0133316-Plumbing (storm lateral)OSHKOSH
ON THE WATER
Job Address 3031 OREGON ST
Contractor KOCH PLUMBING
CITY OF OSHKOSH
No 133316
PLUMBING PERMIT -APPLICATION AND RECORD
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
-Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
Owner JBWC PROPERTIES LLC Create Date 10/06/2008
Category 431 -Industrial-Exterior (other) Plan
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 BeerTap 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
Date 10/06/2008
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 pet a plication within an easement, the City strongly urges the permit applicant to contact the
easement holder ) to secure an , s ppr Is before starting such activity.
Signature Date ~~.- ,6 ^~
Agent/Owner
Address 2005 DOTY ST OSHKOSH WI 54902 - 7040 Telephone Number 920-231-6661 or 235
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.
Coffee Maker
Int Grease Trap
1 Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr. Usage Mtrs
$5,000.00 Plan Approval $0.00 Permit Fees $57.00 ^ Permit Voided
City of Oshkosh
Inspection Services Division
POBox1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
Plumbing Permit Application
01HK fH
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
IJyou are a contractor participating in the Permit Fee Account 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 required, will not be
processed for Permit Issu~anj ce and will be returned for completion. p~ n
JObAddreSS,~/gl d2~~a~~STValue(Includinglaborandmaterials) ~l/~° Date /y-~ -~
Owner ~,4GG~' //~/.f?l~GCr~~/Contractor ~~~fi~ ~~~
^Single Family ^Duplex ^Multi-Family ^Rental ^Commercial Industrial
Number of Fixtures:
Bathtub Disposal Drink Ftn Catch Basin
Whirlpool Dishwasher Wait. St. Wash Ftn
Lavatory Sump Pump Ice Chest Urinal
Toilet Ejector/Grind Exam Sink Gar Drain
Res. Sink Water Softner Sculry Sink Soda Disp
Bar Sink Local Waste Hand Sink Coffee Maker
Water Heater Clothes Wshr F Prep Sink Comm. Ice Maker
^ Gas ^ Elect ~ PwrVnt Bidet Serv Sink Site Drain
Shower Beer Tap Int Grease Trap -Roof Drain
Floor Drain Classrm Sink Ext Grease Trap Standp Rec
Lndry Tray Surgeons Sink R.P.Z. Valve Eye Wash Stn
Lab Sink Breakrm Sink Shamp Sink Wtr Sewer Mtrs
Plaster Sink Dip Well Flr/Wst Sink Deduct Meters
Sterilizer Hose Bibs Wtr Usage Mtrs
Misc.
Fixtures
Electric Contractor (for projects not requiring an EIV Form)
Use /Nature of Work
Size Material Type # Conn. Type
Sanitary Sewer ~(~ /~l/~ C/~T~~iAG- 7 ~_~~J
Storm Sewer (2 XT~~~2
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Water Service
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®C.H Koch Plumbing
d Heating Ine.
2005 Doty Street Oshkosh, Wisconsin 54902 Phone:920-235-0282/920-231-6661
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