HomeMy WebLinkAbout0140601-Plumbing (toilets & lavs) CITY OF OSHKOSH No 140601
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1860 WISCONSIN ST Owner OUR SAVIOR EV LUTH CHURCH Create Date 04/22/2010
Contractor J RASMUSSEN PLUMBING INC Category 443 - Commercial- Interior (Replacement Fixturi Plan
Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters
Shower Lndry Tray Exam Sink Sterilizer Soda Disp Wtr Sewer Mtrs
Whirlpool Sump Pump F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory 2 San Sump /Pump Flr/Wst Sink Bidet Site Drain Misc.
Toilet 3 Water Softner Hand Sink Urinal Wait. St. Fixtures
Kit Sink Standp Rec Lab Sink Beer Tap Ice Chest
Disposal Gar Drain Plaster Sink Dip Well Comm Ice Maker
Dishwasher Local Waste Sculry Sink Drink Ftn Int Grease Trap
Floor Drain Bar Sink Sery Sink Wash Ftn Ext Grease Trap
Hose Bibb Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn
Water Heater
Use /Nature COMM / Replace toilets and lavatories in north bathrooms. * *debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1218910000
Valuation, $11 000 Plan Approval $0.00 Permit Fees $35.00 ❑ Permit Voided
Issued By �'�210 Date 04/22/2010
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 necessary approvals before starting such activity.
Signature
Date
Agent/Owner
Address 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 8887 Telephone Number 920 - 231 -1289
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.
04/22/2010 06:18 9202311289 J RASMUSSEN PAGE 01/01
City of Oshkosh
Inspection Services Division
P 0 Box 1130
Oshkosh, WI 54903 -1130 •
Phone: (920) 236 -5050 �.,111(� �.�
Pax: (920) 236 -5084 Of KQ
ON THE WATER
Plumbing Permit Application
1 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 partic hereto agree to and are bound by said statutes_
• Application(s) and fee(s) can be brought to City Ball, 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 foe, which
ever is greater.
OR
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** Audvisory -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 Issuance and will be returned for coloopletikoa.
slob Address 1 . 8 h a W k -1 c. . jj .. Value (Including Inbar and materials) A - - Da
G'h ,"� Contractor � �L S ^a t~ S S g +3 11 1 � C
Qwlaer �Q_ f s r ar
❑Single Family DDnplelt []Multi - Family (]Rental SComnaercial Dbndustrial
Number of Thtuxrest .
Rohn* _. Sump Pump _...,.— ' Plaster Sink ... goof Drain
San, Sump/Pump Scullery Sink _ Soda Disp _ .. --
Shower .__.., .. -. ___
Service Sink Coffee Mkr
Whirlpool _ _ Water Softener _�. — _
_ 2 Snfndpipc Rec —„ Sharp Oink Site Dram —.._
Toilet __ � (nragc FD Surgeons Sink ^._.._ Waits Stn _ - ...
Kit Sink
S nesl WsRt Sterilizer , -_ -„ ice Chat —.--
fianosnl _.._. -- Bar Sink - -__,_ _ l2PZ Valve Cnmm lee Maker . _.. —
Bidet C* Trap —...—
D)ishv+e.9her „ ..... Artq+krm Sink ...,.— DI GPM
F loor . !.rain t lemur Sink _— Urinal _— -. —_'
Dom Sink Bee Top -- _ Eye Wash Stn
Hose Ril*r A edud Me ter -
F Prep Sink �•,,._- Dipper Well _ ..—
Water Reaper wa Sewer Mrr
i Gas 0 E1ect r1 ParV rat. Floor Sink Drink Fnm — _
Clothes Wshr , _ Hand Sink , Wash Finn _ ,.__ W Usage Mu ---
C .eteb Basin Mime Fittur¢ra .,.____
1.ndry Troy Lab Sink — "^
Elcrctlric Contractor (for projects not requiring an EIV Form)
-
lUse / Nature of Work 12 --al i r c LA-v 1 11- tii•i L — �(J b r 41% 4 141 o f� j -
_ —�_. Si ^ — Material '�_ .___ Type —_ # .—.. -- —. Type
Sanitary Sewer
Storm Sewer
Water Service
•
00/09
Received Time Apr. 22. 2010 6:56AM No, 0675