HomeMy WebLinkAbout0143680-Plumbing CITY OF OSHKOSH No 143680
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1130 N WESTFIELD ST Owner EVERGREEN MANOR INC Create Date 10/14/2010
Contractor J RASMUSSEN PLUMBING INC Category 443 - Commercial- Interior (Replacement Fixtun Plan
Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters
Shower 1 Lndry Tray Exam Sink Sterilizer Soda Disp Wtr Sewer Mtrs
Whirlpool Sump Pump F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory 1 San Sump /Pump Flr/Wst Sink Bidet Site Drain Misc.
Toilet Water Softner Hand Sink Urinal Wait. St. Fixtures
Kit Sink 1 Standp Rec Lab Sink Beer Tap Ice Chest
Disposal 1 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/ Evergreen Manor/ Unit MN1021/ Remodeing the unit to include new kitchen and bath fixtures.
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1608640000
Valuation $4, 0 .00 Plan Approval $0.00 Permit Fees $28.00 ❑ Permit Voided
Issued By
Date 10/18/2010
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.
City of Oshkosh
Inspection Services Division
PO Box 1
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 Of HKOf H
ON THE WATER
Plumbing Permit Application
I 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) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI
54903 -1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the normal permit fee, which
ever is greater.
OR
If you are a contractor participating in the Permit F Account System and have adequate funds, check here
if you want this processed through your account
** Advisory - For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
Job Address /73D ,U.. lets 4--fi 614 / � Value (Including labor and materials) / elpV e ° Date / °-- /5
Owner 4• 9 A 4..„). Contractor J , 4l -4/-e-,, Ply c
['Sin Family ]Duplex ❑Multi Family ['Rental 2Commercial ❑Industrial
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower 1 San. Sump/Pump Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Coffee Mkr
Lavatory 1 Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Wains Stn
Kit Sink / Local Waste
Sterilizer Ice Chest
Disposal / Bar Sink
RPZ Valve. Comm Ice Maker
Dishwasher Breakrm Sink Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Stn
Water Heater F Prep Sink Dipper Well Deduct Meter
0 Gas 0 Elect 0 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink
Catch Basin Misc Fixtures
Electric Contractor (for projects not requiring an EIV Form)
Use / Nature of Work R.Oo At 11A lu / 6,2 / ,eQ o A4
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
06/09
Page 1 of 1
Wolf, Paul T.
From: Rasmussen [rasmuss @charter.net]
Sent: Sunday, October 17, 2010 9:16 AM
To: Wolf, Paul T.
Cc: Ciabatti, Kevin J; dave @packervalley.com; drothe @evergreenoshkosh.com; 'Zachary Rasmussen'
Subject: evergreen apartment remodel
Hey Paul Per our conversation last Friday concerning Evergreen apartment remodel projects. I talked
to the architect and the facility manager, and I was told this section of the building is not rated health
care. A recent extensive building survey was done just last week (Kevin has the plans) and it was
determined that this section of the building is rated —I 1. It is connected by structure (hallway) to the
health care section with fire rated self closing doors. The health section has its own entry and exits,
which means that health care occupants and staff do not have to get into the 11 area to function. I hope
this clears this up and if you have any questions please let me know. Thanks Jeff J. Rasmussen Plg.lnc.
10/18/2010