HomeMy WebLinkAbout0142729-Plumbing (sump pump) CITY OF OSHKOSH No 142729
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 217 N MAIN ST Owner CLOVER INVESTMENTS LLC Create Date 08/23/2010
Contractor D.R. HANSEN PLBG. Category 442 - Commercial- Interior (New /Relocated Fixti 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 FIr/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 COMM / Install sump pump. ""'debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0100140000
Valuation $1,0000.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By 01X.ez Date 08/23/2010
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.
08/23/2010 10:50 19202337466 DR HANSEN PLUMBING PAGE 01
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p O bompodiaa Services Division
I54903 -1130 Rex 1130
Phone: (920) 236 -5050 •
Fax (920)236 -5054
Kan
Plumbing Permit Application nee
I hereby apply for a pantie to do eras install the Ib&owing pig co the premien hereinafter dam, work to conform to the
Wisconsin State Ploughing Coda, in the peraornearce of which all parties hereto agree to and are by said sraasaes.
• APPl moods) sod fees) Can be brought to City Bel, Ream 205 err mailed to Inspection Services, PO 1.125, Odin& W1
54903- 1125. Cow work roil ompezml(s) will reank is foss being deckled or 5100.00 piss normal permit foe, which
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Contractor Advisesy - For applicable pitied; as Elecuical installadon Verificadon (EIF) fiora, .: - by the Electrical
or H0 01 MIX(f r Wdosls, >n be .Pe medby.. the : a be ooboskoed .- •
application. Applications sabtaittedwithoii# ithis - - _ • ` *Mast -
processed for Peat bstimee and win be retuned bar completion.
Job Address .0/ n ma Vane °Wed* biorad le) 000 .a) Date 1/ 3 L ' /O
Owner C
Fes' r S r, . ■(! _ .'
1� , ./ , . d, ■ ,
[aid- Family atad01 _.
Number o'er:
Beate Smip Poop Plotraak
Shower Seri s imptdop Seri ey Sisk �
Weir Saa m -�, , �•kesf rk
Slime Roc Amp Sisk
Toilet Gaup FD Sen sor
L3 - wlt
Iasi War Seo�laer Disposal Hr ffi,t gIZ l i er 1 eBib Sisk t Floor Deb CJam Sick Mod Hose 13ib6 1l:ao Bak Hoer 'ifp WMw r F Pfeil S sk Der W� C7mMet NSir Heat Sick -- ava.�t+ Lay Taw Iab ` Om*Dada e
Electric Contractor (for projects not rcgahiig an EIV Form)
Use 1 Nature of Work _ j (1617111.0 SGCnip p wo
•
� t Cont. Type
Sanititty Sewer
Storm. sewer
Water Service
Received Time Aug, 23. 2010 12:08PM No. 2518 06 /09