HomeMy WebLinkAbout0143896-Plumbing (sump pump) Ca CITY OF OSHKOSH No 143896
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 800 FLORIDA AVE Owner GREGORY A/JACQUELINE J STIEG Create Date 11/01/2010
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 #
1306960000
Valuation $300.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By ay Date 11/01/2010
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.
10/31/2010 16:07 9202311289 J RASMUSSEN PAGE 01/01
City of Oshkosh •
Inflection Services Division
POBox 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050 /�--�
Fax: (920) 236 -5084 QLI1 "
ON TH WAY_
Plumbing Permit Application
1 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 patties hereto agree to taut are bound by said statutes.
• Application(s) and fee(s) can be brought to City Hall Room 205 or mailed to Inspection Services, PO I5ox 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 funds. ' : r . . c i e .. . •.. n : in .,, . . • : J
. '. • . .. ,, , , d have adequate funtds. check hers
. . ; i , , , , s,:re. e : i. SKI Pee° 1r1 IV'i
** Advisory - For applicable projects, an Electrical InstafatiOn Verification (ETV) faun, signed by the Electrical
Contractor or Homeowner. (for insinllations allowed to be performed by die hotmeowne) must be submitted
with the permit application. Applications snbtniited without an ETV when such is reignited, will not be
processed for Permit Issuance and will be returned for completion.
Job Address Roo ° t 2 r: et A Vahle (Including labor and meua abet 3O4 Date
Owner S+1 4.i Con tractor a R S ►K u ..t S e N P i l l I c,
M1Single Family ❑Duplett QMniti- Family (Rental ['Commercial ❑lndastrial
Number of Fixtures:
_ rinnp I Plaster sink Roof I]Qain
Shower ..___ San. Sump/Pomp Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Coffee Mkr - �,._,.
Lavatory Standpipe Rcc — Shame Sink Site Drain
Toils __ Garage FD Surgeon+ Sink Watts Stn , , ,
Kit Sink -- L real Waste Stec 1i r ,,,,� Ice Chest
T)ispaanl Bar Sink RPZ Valve _ _ _ Comm Tea Maker
Dishwasher Breaktm Sink Bidet Int (henna Trap _ _ _
Flax Amin _ C1aa rot Sink Urinal En Ore. ie Trap
Now Bibb Exam Sink _ Beer Tap , Pyc Wash San
Water Hooter F Prep Sink Dipper Well Deduct Meter „_.,,,,-
liar i 1 Rlcct n PueVnt Floor sink [)rink FM Wtr Sauer Mtr
Clothes Walrr Hand Sink Waal, Fr Wu' Usage Mn
Tandy Tray Loh Sink _ Catch Bas Min c P corral Electric Contractor (for projects not requiring an EN Form)
Use / Nature of Work 9—. t:, $ P •
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
08/0?
Received Time Oct. 31. 2010 4:48PM No. 3515