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Home My WebLink About0143902-Plumbing a CITY OF OSHKOSH No 143902 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 465 N MAIN ST Owner STAPEL PROPERTIES I LLC Create Date 10/04/2010 Contractor SOPER PLUMBING Category 442 - Commercial- Interior (New /Relocated Fixti Plan FIL -410- 1010 -P 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 1 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 1 Floor Drain Bar Sink Sery Sink Wash Ftn Ext Grease Trap Hose Bibb Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn Water Heater 1 Use /Nature Interior alterations for new restaurant at 9 Church Ave to include electric water heater and grease interceptor per of Work approved plan. Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcel Id # 0700220000 Valuation $1,40 .00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided Issued By 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 2225 BURNWOOD DR OSHKOSH WI 54902 - 9003 Telephone Number 426 -2151 To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of Inspection (Le. 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 R Inspection Services Division P O Box 1130 Oshkosh, WI 54903-1130 OCT 2 7 2010 Phone: (920) 236 -5050 DEPARTMENT Fax: (920) 236 -5084 COMMUNITY DEVELKO.lH INSPECTION SERVICES DIVT1(f 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 e 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 C (i iu,W / ,4t/L) Value (Including labor and materials) / y� D /c - .; 2 7/a �!4' Al. Nk►;'. ft. t Owner Contractor /. ❑Single Family ❑Duplex ❑Multi- Family ['Rental XCommercial ❑Industrial 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 Sham Sink P Site Drain Toilet Garage FD Surgeons Sink Waitrs 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 1 F Prep Sink — Dipper Well Deduct Meter ❑ Gas jj'Elect ❑ 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) e .--)/ , �e-- oiC Use / Nature of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service 06/09 City 4110) Division of Inspection Services 215 Church Avenue PO Box 1130 Oshkosh WI 54903 -1130 Of —KO, f f ---I Offi 920 - 236 -5050 ON THE WATER lax 920- 236 -5084 Electric Installation Verification I (We) (Electrical Contractor Name or Homeowner's Name) (Address) (City) (State) (Zip Code) accept the responsibility to perform the electric work as stated below, at the following address: r lt/ CilLV1/ Q4 (Address where work will be performed) The nature of the work consists of: (Check One or Describe the Nature of Work) Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser. Reconnection or new circuit for replacement Electric Water Heater or power vented water heater. Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and lighting fixtures due to siding / soffit installation. Note: New Service Entrance Cables will require a separate permit. Reconnection or new circuit for the replacement of other permanently wired appliances / fixtures. New circuit for the addition of A/C to an individual dwelling unit, including required service electrical outlets. Note: Homeowners can only do their own electric on a single family owner occupied home. Work on a condominium, duplex, rental, or multi -use building would require a licensed Electrical Contractor. Other The value of this work is $ /5 I hereby verify this work will be performed in compliance with the License requirements of Section 11 -22 of the Oshkosh Municipal code and further verify the reconnection / installation will be done in compliance with manufacturer and Electric code requirements. c frk Ca at/at,/ / r gnature of Company Officer or Homeowner � P Y Homeowner) (Print Name) (Date) 07/07