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Home My WebLink About0144451-Plumbing (RPZ) CITY OF OSHKOSH No 144451 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 112 OTTER AVE Owner WINNEBAGO COUNTY Create Date 12/22/2010 Contractor D.R. HANSEN PLBG. Category 440 - Industrial- Interior 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 1 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 Install RPZ to serve boiler feed water supply. Valve shall be tested at time of installation and registered with the Dept. of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service • Parcel Id # 0200250000 Valuation 00.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided Issued By Date 12/22/2010 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. 12/21/2010 13:38 19202337466 DR HANSEN PLUMBING PAGE 02 City of Oshkosh Inspection Services Division ` PO Box 1130 Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 Fax: (920) 236 -5084 0/1—#CO,[H ON THE WA k 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 marled to Inspection Services, PO Box 1128, 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 Jfyou are a contractor . ar i • in. i the Permi • nt stem and have adeauate funds. check here if you want this processed through your account *" Advisory - For applicable projects, an Electrical Installation Verification (ETV) 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 11'a nil-[.t- Are - Value (Includin labor and materiels) M Soo. °° Date 1'0121110 Owner Wi nnclrkngo ( - 4 Contractor "4".).R . A n 'P►urn b i 1—i.C. []Single Family []Duplex :Wald-Family ['Rental E ommereial pindustrial Number of Fixtures: Bathtub Sump Pump Planer Sink Roof Drain Shower San. Sump/P®p Scullery Sink Sod. Lisp Whirlpool Water Softener Service Sint Coffee Mkr Lavatory Standpipe Rim Slump Sink She Amin Toilet Garage FD Surgeons Sink Weitrs Sur ICit Sink Local Waste Sterilizer Ion Chest Disposal Bar Sink RPZ Valve Oman km Maker Dishwasher Bradam Sink Bidet Inn Greaser Trap Floor Drain Classrm Sink Urinal En Grease Trap Hose Bibb Eau Sink Beer Tap Eye Wash Stn Water Heater F Prep Sink Dipper Well Deduct Meter ❑ Gas o Mecca Pwevol Floor Sink Drink Fo o vvtr Sewer Emir Clothes Wshr Hand Sink Wash Fun Wtr Usage Mk L ndry Tray Lab Sink Catch Basin Miso Fomars Electric Contractor (for projects not requiring an EIV Form) Use / Nature of Work I(\ ail • Tip \slue Size Material Type ii Conn. T - Sanitary Sewer Storm Sewer Water Service Received Time Dec. 21. 2010 1:57PM No. 4132 06/09