HomeMy WebLinkAbout0141773-Plumbing (laterals) e CITY OF OSHKOSH No 141773
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 452 N MAIN ST Owner JOHN J /KATHLEEN A SAKSCHEK Create Date 06/29/2010
Contractor D.R. HANSEN PLBG. Category 444 - Commercial - Exterior Laterals 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 Install strom lateral and correct storm discharge violations per orders.
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer 6" Plastic Lateral 1 New
Water Service
Parcel Id #
0400950000
Valuation $1, 00.00 Plan Approval $0.00 Permit Fees $50.00 ❑ Permit Voided
Issued By Date 06/29/2010
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.
06/28/2010 12:31 19202337466 DR HANSEN PLUMBING PAGE 01
In p of Oshl
Inspection Services Division
( 1116 )
PO Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 2305050
Faoc (920) 236-5084
N TM WA R
Plumbing Permit Application
I ley apply for a permit to do and install the following plumbing on the premises hereinafter descant the work to woform to the
Wisconsin State Plumbing Code, in the performance of which all patties hereto agree to and sin bound by said mantes.
• App (s) and (s) can be bray* to City Sall, Room 205 or marled to Inspection Services, PO Box 1128, Oshkosh WI
54903 -1128. Commencing wore wtthora permit(s) will result in mss being doubled or 5100.00 plus the normal permit fse, which
ever is greater.
OR
• • , • • . ' r , , ", • ' , - ' e r , it ee.4c ‘ t „ 'I. • ■_•. - a •• • - .._, ,_ . . •
if you want thi4 processed through yoxr account '4
** Advisory - For applicable projects, an Electrical Installation Verification (Erg) farm, signed by the Electrical
Contractor e t Ho/mown= ( for : allawed.to be pe f o r d b y t1e, 0!arDwi ) Must be solnuititd
. with the permit application. Applications aubmittad without akEirwlieninich Umpired, arili not be
p cocemed for Permit Issuance and will be manned for acute.
Job Address q 5a ru n Valve ondwrag moron' on' arterials) 4 L co i CK' , Date (4A// o
Owner 3611n Ka-thy Sc4 kTht - Contractor D ' sw at ! _L, . AILO
DSnagle Family DDaplex QMalti,- Family seater 0/Commercial 1111
Number of Futures:
Biem* sani Pap Pharr Sint Roott robe
Shower See_ Saeaary Sisk Soda Dip
Whirlpool W.rrsooeas Shake coarse Mkr
Lamm Sic Data
Toilet Gunge FD Salk Wain Sir
Kit Sink Local Wars Sheik= roe Clam
Disposal Di Rik RPZ Viva Cams Ica Moh r
Dishwasher Bid= Sink Bidet rat ODaee Trap
Floor Drab Chinn Sisk Mini Bat aurae Tap
Free Dibb Berm Sink Door Tep Tye Wadi Sin
Wader Trees F Prep Sink Dipper Well Dearettdetrr
0 G e e 0 E l e a El NINieR . Watr Sewror lnttr
... Fl Sialc
accrue Weir Hind si k Wait Pin .
r am tlrra. bar
Lab Sint Grab Mud Meares
Electric Contractor (for projects not requiring an EIV Form)
Use / Nature of Work JU- C9 cf i ' k r (.54 064 JF,
Sine Material Type # Caron. Type
Say Sewer
Storm Sewer (p 0 V o.,
Water Service .
Received Time Jun, 28. 2010 1:49PM No. 1690 06/09