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Home My WebLink About0144078-Plumbing (sanitary sewer) CITY OF OSHKOSH No 144078 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1002 N MAIN ST Owner STEVEN T SOSNOSKI Create Date 11/15/2010 Contractor VALENTINE READER PLUMBING INC Category 445 - Commercial - Exterior Other 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 FIrIWst 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 Secure sanitary sewer for building raze /remodel due to fire. of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcel Id # 1001410000 Valuation $20.00 Plan Approval $0.00 Permit Fees � $25.00 El Permit Voided Issued By Date 11/15/2010 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 secure a nece ary approvals before starting such activity. Signature C6 ) t � Date /A / S d7 / � Agent/Owner Address W 2015 INDUSTRIAL DRIVE KAUKANA WI 54130 - 7517 Telephone Number 920 - 788 -2494 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 P O Box 1130 Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 Fax: (920) 236 -5084 OfHKOJH ON THE WATER 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 participatingin the Permit Fee Account System and have adequate funds, check here if you want this processed through your account (l ** 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 ETV when such is required, will not be processed for Permit Issuance and will be returned for completion. Job Address / 00g tl) /kb: i V tcv% Value (Including labor and materials .2 06 ' 6.4' Date /t L /5'9:00 Owner Contractor R 0JI> ❑Single Family ['Duplex EMulti-Family ['Rental Commercial ❑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 Shamp Sink 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 Classrrn Sink Urinal Ext Grease Trap Hose Bibb Exam Sink Beer Tap Eye Wash Stn Water Heater F Prep Sink Dipper Well Deduct Meter ❑ Gas ❑ 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 fip1: or R 4,,,7"— Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service 06/09 REQUEST FOR EXCEPTION TO REQUIRED SEWER AND WATER ABANDONMENT REGULATIONS Date j / -/s /6 Address of building /00 2.. / .3 I, Name of Owner ) ve.i fiGor I '- CA.A .r Address of owner /D D Z N. /Vj7 /,. S'l- The undersigned Master Plumber requests that the requirement for abandonment of the sewer and water laterals for this address not be required to meet the ordinance for abandonment at the property line before raze or removal of the served structure. (Check one or provide Information) • The utilities will be reused for new construction at this site within twelve months of the date of request for exception. If the utilities will not be reused within this time frame they will be properly abandoned at the property line per ordinance requirements no later than twelve months from date of this request. • The utilities will be properly abandoned after the structure is removed to make the I I utilities accessible for abandonment. The utilities will be secured against damage during demolition and until they can be abandoned to meet the requirements of ordinance. (Not to exceed 60 days) • Other reasons for the requested exception: I I (Continue on the reverse side of form if necessary) Master Plumber C/ Mr) fl Date / /-/5 -,9010 • Master Certificate Number a 31 Q S's Mailing address tJ a-vS. esIli ; 4 / d ile LikQ.. w 3-.5730 Approved: r Date / /' /)'/ d Plumbing Inspector)