HomeMy WebLinkAbout2010-Plumbing (underground drains) CITY OF OSHKOSH No 140644
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 744 W 4TH AVE Owner JAMES J EMERSON Create Date 04/23/2010
Contractor D.R. HANSEN PLBG. Category 410 - Residential- Interior 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 San Sump /Pump Flr/Wst Sink Bidet Site Drain Misc.
Toilet 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 SFR / Replace underground drains. * *debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0603450000
Valuation $500.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By Date 04/23/2010
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 55 KNAPP ST OSHKOSH WI 54902 - 3448 Telephone Number 233 -1595
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.
ili 04/21/2010 11:01 19202337466 DR HANSEN PLUMBING PAGE 01
City of Oshkosh
Ikon Services Division
PO Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: ( 236 -5084 00:1001
Plumbing Permit Application 'Ew
1 hereby apply for a paw to do and install the hollowing plumbing on the premises hereinafter described, the work to conform to the
Wisconsin Stems Plumbing C ode, in the paf rmauoe of which all parties beret* agree to and are bound by said st nnos.
• iicthcai(s) aid fee(s) cmi be brought to City Dail, Roan 205 or mailed. to 1n cdan Services, PO Bas 1128, Oshkosh WI
54903- 1128. Coimmerscing work without permit(s) will result in fees being doubled or S100.00 phi the normal permit fee, which
ever is greater.
OR
1 , , e a , , - ctor , , .i i , ati - , t e ' ern,' e Ac . , rte , ,. , . , f_ , a ads• !t . , ,_ ,
Ilex waist this throxgh your account _
" Advisory - For applicable projects, an lloct icol Installadon Verification (UV) fonn, sib by the Electrical
Contractor or Homeowner (farlostalladnvi atlawed.to.be .perfonacd by the ouo
o!R nuiatbe submittal .....
. with the pen* application. Applications submitted widioatintritirliiiiiniliii xecpciiiil, Will EMU •
processed for Permit Issuance and will be returned for completion.
Job Address 744 ai) 'i Value n rimmed umerirs) 45610 .0E1 Date 1 6 l /
Owner 01 ,rS611 Contractor D. R. Hansty, P1 t,cm banes
DMadti4ftt Dk i*1 cwilstro
Number of Fixtures:
t
Showier
seining
Water Sultans Smite Sink Cam _
`v a
L she Sec skew sit Site Thai
Toilet
Garage FD Suwon Sint( Weine see
KM Sink Loud Waene steer
seer (:teat
Dimond err slots RfZ Vain Caren Toe Miwr
Dirnani nr and= scot Bine Gums Iry -
Flow Drain, Ouncm Sit Using p.see Tip
Has BSA Elea. Sant Bar Tor Byv wan sat
VAMIlilmim F Pap Sink Dicer Wei Dacha Maar
0 Cis 0 Sleet PerVnt
mow WTI: Da*Pim ..suer Sewer t+
Henn A* wasitAnn " War.
Lna`y Trey Sink olds Basin td1'io Foos
Electric Contractor (for projects not requiring an EIV Form)
Use / Nature of Work YQ ezi e Ell/Ida-9 uii° 4c ii1
Size Material IN/Pe • Corn Type
Sanitary Servr
Storm sewer
Water Service .
Received Time Apr. 21. 2010 12:19PM No,0665 06/09