HomeMy WebLinkAbout0133585-Plumbing (city rehab)OSHKOSH
ON THE WATER
Job Address 748 W 17TH AVE
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner STEVEN J RICHMOND
Category 410 -Residential-Interior
No 133585
Create Date 09/11/2008
Plan
Contractor KEITH PETERSEN PLUMBING
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
UselNature
of Work
Valuation
Issued By
_ Shower Water Softner Wait. St. Shamp Sink
Floor Drain 1 Local Waste Ice Chest FIrIV11st Sink
Lndry Tray Clothes Wshr Exam Sink Catch Basin
_ Disposal Bidet Sculry Sink Wash Ftn
Dishwasher Beer Tap Hand Sink Urinal
Sump Pump 0 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
2 outdoor silcocks
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Vaive
Eye Wash Statn
1 Wtr Sewer Mtrs _ _ _ _
Deduct Meters
Wtr Usage Mtrs
Date 10/20/2008
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 Cit ugly urges the permit applicant to contact the
easement h to se re any a r activity.
Signature Date 2 /
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Agent/Owner
Address--1600 HAMILTON CT
LITTLE CHUTE WI 54140 - 2534 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 pertormed within two business days from the time the project is ready.
~ $2,892.00 Plan Approval $0.00 Permit Fees $28.00 ^ Permit Voided
City of Oshkosh
Inspection Services Division
POBox1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
Plumbing Permit Application
01HK01H
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 partic~a inQ in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account n
** Advisory -For applicable projects, an Electrical Installation Verification (Elm 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 ,an/ d will be returned for completion. ~1~ QQ~~
Job Address ~ L/~ ~J ~ 7~ Value (Including labor and materiafsl ~, JO 2~ ~D D`a,,te B~
Owner ~J~~ictdMta,~~U Contractor ~~"~ ~~~~ (~~U.Yr~~lfl~
~ingle Family ^Duplex ^Multi-Family [Rental ^Commercial UIndustrial
Number of Fixtures:
Bathtub Disposal Drink Ftn
Whirlpool Dishwasher Wait. St.
Lavatory Sump Pump Ice Chest
Toilet Ejector/Grind Exam Sink
Res. Sink Water Softner Sculry Sink
Bar Sink Local Waste Hand Sink
Water Healer Clothes Wshr ~ F Prep Sink
Gas C Elect ~ PwrVnt Bidet Serv Sink
Shower Beer Tap Int Grease Trap
Floor Drain ___f ____ 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
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 S[n
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
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