HomeMy WebLinkAbout0143719-Plumbing (laterals) Ill CITY OF OSHKOSH No 143719
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 920 MOUNT VERNON ST Owner BRUCE M /CYNTHIA L WELLHOEFER Create Date 10/18/2010
Contractor SBS PLUMBING LLC Category 401 - Residential - 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 3" storm lateral with tracer wire for sump and gutter discharge.
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer 3" Plastic Lateral 1 New
Water Service
Parcel Id #
1002440000
Valuation $600.00 Plan Approval $0.00 Permit Fees $50.00 ❑ Permit Voided
Issued By)) Date 10/19/2010
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 4635 RED FOX RD OSHKOSH WI 54904 - 7784 Telephone Number 920 -410 -5933
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.
:t 18 10 07:23a 9202303657 p,1
City of Oshkosh ,.�•�
Inspection Services Division 'r ,
P O Box 1130 '
Oshkosh, WI 54903-1130 \ i t
Phone: (920) 236 -5050 \--.......,/
Fax: (920) 236 -5084 : i -, I
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 throut,h your account
'k* Advisory - For applicable projects, an Electrical Installation Verification (EN) 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 Mt 14 '4%4 a ,�
Value (Including labor and materials) Date IO /P6hi)
Owner �- 4->el/h64 Of Contractor 55S itvw.b,A:4.
Single Family [Duplex DMulfi- Family [Rental [Commercial Dlndustrial
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San. Sump/Pump Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink
Coffee Mkr
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitrs Stn
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Vah;e Comm Ice Maker
Dishwasher Breakrm Sink Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal ha rt Grease Trap
Hose Bibb Exam Sink Beer Tap Eyo Wash Ste.
Water Heater F Prep Sink Dipper Well Deduct Meter
J Gas U Elect U PwrVnt Floor Sink (rink Fntn
Wtr Sewer Mir
Clothes water Hand Sink
Wash Fntn Wtr Usage Mu
Lndry Tray Lab Sink
Catch Basin Mire Finlures
Electric Contractor (for projects not requiring an EIV Form)
Use / Nature of Work ('o4 ;•� ' t s- S A. ,- f6 .4 c ph„i (z) 4- sLiw , iL. 0)
Size Material Type fir Conn. Type
Sanitary Sewer
Storm Sewer
-w, 7P a c4 3 3K' ..w yo e - al 6 l '4r_
Water Service
06/09
Received Time Oct. 18. 2010 9:21AM No, 3308