HomeMy WebLinkAbout0141995-Plumbing (laterals) i l CITY OF OSHKOSH No 141995
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 609 N MAIN ST Owner IMK PARTNERSHIP Create Date 07/13/2010
Contractor J RASMUSSEN PLUMBING INC 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 Scully Sink Drink Ftn Int Grease Trap
Floor Drain 1 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 / Seperate storm & sanitary sewers. *"debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer 6" Plastic Lateral 1 New
Water Service
Parcel Id #
0700660000
Valuation $2,000.00 Plan Approval $0.00 Permit Fees $57.00 ❑ Permit Voided
Issued By � 4vX/a/ Date 07/13/2010
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 (Le. 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.
07/13/2010 06:44 9202311289 J RASMUSSEN PAGE 01/01
City of Oshkosh
Inspection Services !Aviators FnBox1130
Oshkosh, WE 54903 -1130
Phone: (920) 236 -5050
ON THF; WATER
Plumbing Permit Application
1 hereby apply for a permit to cki and install the following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, in the perfo mane of which all parties hereto agree to sand are bound by said statutes.
• Appiication(s) and fex(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Rox 1128, Oshkosh WI
54903 -1 128. Commencing work without permit(s) will mutt in fees being doubled or S100.00 plus the normal permit fee, which
ever is greater.
OR
1 , ,r• .c .r ..r ' 1, a ih , the • r ii Sysicr and have elequa1e f;ywds. cheek here
if you It a►ct thl t.Arocess l rhroirrgh yo a
** .Advisory - For applicable projects, an Electrical Installation Verification (EIV) foam, signed. by the kcal
Contractor or Homeowner (for insWilla tions allowed to be performed by the homeowner) must be submitted
with the permit application. Applicatiiotaa sabmiitted without an EIV when suit is required, wlll tttotbe
processed for Permit Issuance and will bc.retarneg for completion.
Job Address 4 01 ii). "frt.) value (Including laor h and materials), Z O p - Date 7
Owner Do rSz, Contractor 't Jl t S b, t,„ i 1 e r:I P 11 , T C .
DSingle Family DDaplex DlVialti- Family []Rental lCommerdai Dlndusirial
Number of Firtares;
Radmth -_ Sang, Pump -- piaster sink Reel: rain -
Shower - San. Stunp/Famp �.....,.- Scullery Sink . - -- Soda Div _T
Whirlpool „_ Water Softener Service Sink _ Coffee Mar -
twain Standpipe Rea: _ Slump Sink Site Arvin
Toilet .. Garage Ft) „._ Surgeons Sink -- Wallis Sin
Ktt Sink , , Local Waste Sterilizer _ ice Chat --
Diap l _ _ Bor Sink _ RPZ Valve Gram Its Maker .
Diehwasha Rreakrrn Sink Stitet — int Orem Trap -
Floor Drain ^.1, ClaeAnn Sink — Urinal Ext Brame Trap
Hose Bibb _, dram Sink -- Seer Top — Eye Wash Stn
Water Reeks. F Prep Sink _„ _ -- Dipper Well _ Dethiet Metro
1:1 Craa 11 Elect n Pwrvm Fleor Sink - Think r ate Wit Sewer Mtr
Cloth et Willa. [land Slnk Waah Finn Wit Urine Mir Lndry Tray C ah Sink .— __ CMeh Basi M ,_ ,-- Miac Pinata _ - -
Electric Contractor (for projects not irequiring an EiV Form)
Use / Nature of Work . ' , .ti - 4•0 t _ 4- -f Pc" i fat c.v.+ 4.4-s
Size Material Type # Conn. — R �
Sanitary Sewer
Storm Sewer t:),, P v G .r - k l i 0
Water Service
L_.... _. — .. -
osies
Received Time Jul. 13. 2010 7:23AM No. 1873