HomeMy WebLinkAbout0144477-Plumbing (2 toilets) g CITY OF OSHKOSH No 144477
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1000 N WESTFIELD ST Owner EVERGREEN RETIREMENT COMM INC Create Date 12/28/2010
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 FIr/Wst Sink Bidet Site Drain Misc.
Toilet 2 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 Apt #513 / Replace water closets (scope of work added to permit #144274)
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1608650000
Valuation $ 0.00 Plan Approval $0.00 Permit Fees
$0.00 ❑ Permit Voided
Issued By
Date 12/28/2010
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.
12/27/2010 08:34 9202311289 J RASMUSSEN PAGE 01/01
tarty of Oshkosh
1n ctin Services 1,1lvisi0li
F O113nx 1190 •
OshlLt►sh, Vii 54943 -J 130 ' •
Mope: (920) 236-5050
Fax (920) 236 -i0 &4 �/� r� j
Plumbing C /� of l l\l�C,/ I 1
Perm`t Application
ON rN� WATER
1 bdreby apply for a permit to do and install the ,fallowing plumbing n the
Wisconsin State latumbirt C'o 8 premieres hereinafter described, the work to conform to the
F dc, in the p ormance of which all parties hereto agree to and are, bound by said statutes.
• lApplication(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 Si0O.0Q plus the normal permit fee,,, which
lever is greater.
OR
if • you it Jti „.9.cL� a tough yQmr - acorn �• e t �� have equate funds eheclr Iterc
** Advisory . For applicable projects, an Electrical Installation Verification (ETV) form, signed by title Electrical
Contxactorr or Homeowner (for installations allowed to be peed by the homeowner) must be submitted
with the permit application. Applications snbttdttcd without an EIV when such is reglixea, will not be
processed for Permit fiance and will be .retuned for completion.
DC
Job Add rise, /e c a N, w°- Value (o,at,ding la>w,r and nmtcrkdp) / °' _ Date 12 — ' 2 ‘f.—/ o
Owner < 0.w- 0,..4'. Contractor . 't Rs h4. t .s s e N P I , . fir c
DSIngle Family DOopler IMniti- Family DRentai
DC�►mmertiAl D itnanstrlAl
Number of Fixtures:
Bathtub Sump Pump Plaster Sink RAOfTlaain
Shaw Stn. Sump/Pump - ,^-~ ----
....,__ Scullery Sink Soda Nap Woos. Softener Whirlpool
— — Service Sink ^..-.� Coffee Mkr
Srandpipc Ree Shemin Sink
Tollei Site Drain
— Gone Ft) Surgeons Sink. -- Kit Sir*
Stn
. f..ocal Waive • Stcrilirart -
t?igwvnt...... _ Ie a Chat
_ -- _ r3erS Sink Rr7 Valve __
Comm ice Maker
Dishwasher ... Breakmr Sink -- Met � 1 � .,.. . ---
�� Grime • Trap
Urnin Cinsprnt Sink �"�` l� --
Th 13oa 'M eBibb Exam Sink BeSr Taft T _ n Trap --- Wnta Heater �� F Prep 51»k Eye Wash Stn
writer a Fitter. f 1 ArrYnl ,- —_ Dipper well Deduct Meter
-
Finer Sink
Clothes Vflahr Band Sink ...—_ ,. Think ` " - -- WV Scorer lulu -
Lndry Tray --.. . Wean Fntn Wp tinge _
Lab Sink Catch Htwin T .
Mac Pp(tara
Electric Contractor (for projects not requiring an EIV Form)
iise / Nature of Work . ft h P 4 4A., .1- * 1 V a 7V
_w size _... - -____ - -..._.—
Material Typc #
i M Conn, Type
Sanitary Sewer
Storm Sewer
Water Service
06/49
Received Time Dec.27. 2010 8:15AM No. 4175