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Home My WebLink About0144214-Plumbing (laterals) CITY OF OSHKOSH No 144214 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 130 W 23RD AVE Owner KENNETH M VOSS Create Date 11/29/2010 Contractor D.R. HANSEN PLBG. 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 FIr/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 Repair sanitary sewer lateral. of Work Size Material Type # Conn. Type Sanitary Sewer 6" Plastic Lateral 1 Repair Storm Sewer Water Service Parcel Id # 1402800000 Valuation $2,000.00 Plan Approval $0.00 Permit Fees $50.00 ❑ Permit Voided Issued By , Date 11/29/2010 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 55 KNAPP ST OSHKOSH WI 54902 - 3448 Telephone Number 233 -1595 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. 11/29/2010 10:13 19202337466 DR HANSEN PLUMBING PAGE 02 City of Oshkosh Inspection Services Division P O Box 1130 Oshkosh, W154903 -1130 Phone: (920) 236 -5050 Fax: (920) 236- 5084�'� • • ONTNE A R 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 feels) 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 ee Account Sy ;tuft and have adequate funds, check here i • _ . • , - , , -seed throu - h our , , !I ** Advisory - For applicable projects, an Electrical Installation Verification (ETV) form, sued 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 13Q wka Ave • Value (Including labor and ) 4 aCCO • Date 1 Owner yn.� KQiY 4 L Contractor 13 .R. 1-1rur r-) TALIM ['Single Family ❑Duplex [Multi- Family Mental ['Commercial ❑L dluarb l Number of Fixtures: Bathtub Sump Pump Plaster Scale R Drain Shower San. Sump/Pump Scullery Sink Soda Dap Whirlpool Water Softener Service Sink Ceiba Mr Lavatory Standpipe Rim Shamp Sink Site Aria Toilet Gump FD Surgeons Sink Wait,, Stn Kit Sink Local Waste Sterilizer Ice Cheat Disposal Bar sink RPZ Vane Comm Ice Mdotr Dishwasher Breakrm Sink Bidet Int Grease Trap Floor Drain Chssrm Sink Urinal Eat Grove Trap, Hose Bibb Exam Sink Beer Tap Eye Wash Stir Waver Heater P Prep Sink Dipper We11 Deduct Meyer o Gas 0 Meet 0 PwrVnt Fluor Sink Drink Prima Wtr Sewa Mtr Clothes wane Hand sink Wash Fran Wtr usage Mir lanky Tray Lab Sink Caren Saki Mac Fixtures Electric Contractor (for projects not requiring an ETV Form) Use / Nature of Work RF1?gjc ► ..- r Size Material Type # Conn. Type Sanitary Sewer Storm, Sewer Water Service Received Time Nov, 29. 2010 10:32AM No, 3872 06/09 11/29/2010 10:13 19202337466 DR HANSEN PLUMBING PAGE 01 D.R. HANSEN PLUMBING 55 KNAPP ST OSHKOSH, WI 54902 -3448 PHONE: (920) 233 -1595 FAX: (920) 233 -7466 FAX COVER SHEET DATE: 104110 1 0 I a . s o FAX* q ao • a 1 314) -5064F TO: 64 oQ Osh ( , h ATTN: FROM: D.R. HANSEN PLUMBING NUMBER OF PAGES: Oa (INCLUDING COVER PAGE) RE: PlUmbit5 i+ ApetiCation Received Time Nov.29. 2010 10:32AM No.3872