HomeMy WebLinkAbout0144274-Plumbing (kitchen sink) (?-1) CITY OF OSHKOSH No 144274
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1000 N WESTFIELD ST Owner EVERGREEN RETIREMENT COMM INC Create Date 12/03/2010
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 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 1 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 Apt #513 / Replace kitchen sink. * *debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1608650000
Valuation $1,500.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued B y 6 Date 12/03/2010
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.
12/03/2010 11:08 9202311289 J RASMUSSEN PAGE 01/01
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903 -1130
•
Phone: (920) 236 -5050
Fax: (920) 236-5084
ON 11.1 . ATER
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 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 lug, Oshkosh WI
54903 -1128. Commencing work without permit(s) will result in fees being doubled or 5100.00 plus the normal permit fee, which
ever is greater.
OR
1 • _ are a • n r. ,r • ar ' -satin:- ' the ' : mit F ,_ e. ccaunt . clam a, f ave a • • r uate ,'• ch- ere
Lvou want this Processed throuvh 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 retained for completion.
Job Address / 000 .J. !` 421+1.1 Value (Including labor and materials) 1 S 0 n • ° ` Date l Z' 3-/ o
Owner ry 5y. . fk oars 4 S') 3 Contractor , 1 ki°r1 rh IA s S P I, i F1%. , G
❑Single Family ❑Duplex AMulti- Family ❑Rental []Commercial . [,'Industrial
Number of Fixtures:
Pathtub Sump pump Plaster Sink Roof Drain
Shower San. Sump/Pump Scullery Sink Soda D1sp
Whirlmnl .. _ -- Water Softener _ —..., Service Sink _ Coffee Mkt .
Lavatory Standpipe Rea Slump Sink Site Dram
Toilet Garage FD Surgeons Sink Waits Stn
iii. .li11K 1 :_i.::iii W u0iw ecvri;i.ccr i:'E `foie'!
47.7. D.. c:,1. E,:7, 1/2.14m. r . � .... T u.1 -.
,;
Dishwasher Breakrm Sink Bidet Int Grease Trap
F,,,. r►"in Clsssrm Sink Urinal Ext Grease ?tap ____
;arm- R64., r T Exam Sink Beer Tap Eye Wash Stn
Wad Homer F Prep Sink Dipper Well , Deduct Meter
Gan _ Elea _ PwrVnt Floor Sink Drink Fnm WR Sewer MIT
Clothes Wshr Hand Sink _ Wash Fnu Wtr Usage Mn _
Lndry Tray Lab Sink _.. Catch Basin „_ -- _ Mice Fixtures ...... 4444.
Electric Contractor (for projects not requiring an EIV Form)
Use / Nature of Work
Size Material Type # Conn. Type
Sno0.,7 s?
Storm Sewer
Water Service
06/09
Received Time Dec. 3. 2010 10:49AM No.3929
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