HomeMy WebLinkAbout0142479-Plumbing (sump pump) le CITY OF OSHKOSH s» I Nhp}, 142479
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD -910
ON THE WATER OAtt
Job Address 465 WINDINGBROOK DR Owner MARK A/JANET C ROHLOFF Create Date 08/09/2010
Contractor J RASMUSSEN PLUMBING INC Category 413 - Res - Interior (Replacement Fixtures) 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 1 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 sump pump. *"debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0614402200
Valuation $300.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By a Date 08/09/2010
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.
08/07/2010 06:27 9202311289 3 RASMUSSEN PAGE 01/01
City of Oshkosh
Inspection Service. Div1310n
P 0 Box 1130
Oshkosh, W154903 -1130
Phone: (920) 236 -5050 0
Fax: (920) 2.36 -5064 Of-KOJH
Plumbing Permit Application) nN THE bvATFp
T 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) an be imw ht to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI
54903 -L 128. Commencing work without permit(s) will result in fees being doubled or 5100.00 plus the normal permit fee, which
ever is greater.
OR
Laam are a conlracsor perrictpatinejteche Permlr F ,ccount $y_sig and have acitiv alre funds, check here
it lieu wane this procesItt,t,/jt:qu„g, ,y 1 for accolate .
** .A.dvasory - For applicable project, an Electrical Installation Verification cation (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) most be !abstained
with the permit application. Applications submitted without an EIV when such is respired, will not be
processed for Pe mnit Issuance an,d will be rammed for completion.
.lob .Address 94 r "t- - 4k ( 3 a9 _ ° - � ... 7Z to
Va.1De lrrcl,rdmg lairrrr and medals) at e -7
Owner Contractor t R 0 . S >.... s s e P I t , x7,- c:
single Family Duplex - D M n it i -F roily DRental [Commercial Dlndnstrial
Number of Fixtures:
fl OM*, __ Sump Pump _____ Floater Sink Roof Amin
Shower _ -- San. Sump /Pomp Scullery Sink __ _ Soda Disp
Whirlpool _ Water Softener Service Sink Coffee Min
Lavatory .Standpipe Rex. . —_.... Skimp Sink - -- Site train
Toilet (linage I'L1 Surgeons Sink __ WRltr4 Sm .�
Kit Sink -- - [neat Waste -- Sterili�ar lee Chat -
Disposal --. Her Sink ^_ ._.,.. RPZ Volvo __ Comm Tee Maker
-.
Diahwaaher Rneaksm Sink Bidet — Int Grease Trap _ .`—
Floor Drain Cinsum Sink Urinal Eat Gram Trap
RAU Bibb P.xam Sink Boer Tap Eye Wash Stn �
Water Tiarter F Prep Sink __.— . Dipper Well Deduct Motor
i'.: Gas LJ Elect Cl PwrVnt Floor Sink Drink Fern Wa Sows Mir
— •......_.._
C oibcs Wclrr Hand Sink
Wash Foul Wu Usage Mir
Lndry Tray Lab Sink - -_
C+tdt Again Mite Fixtures
Electric Contractor (for projects not requiring an .ETV Form)
Use / Nature of Work - p (& c.c .�. B
Size Material Type f Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
00/011
Received Time Aug. 7. 2010 7:07AM No. 2317