HomeMy WebLinkAbout0144476-Plumbing (interior alterations) CITY OF OSHKOSH No 144476
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1080 N WESTFIELD ST Owner EVERGREEN VILLAGE Create Date 12/28/2010
Contractor J RASMUSSEN PLUMBING INC Category 442 - Commercial- Interior (New /Relocated Fixti Plan
Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters
Shower 1 Lndry Tray Exam Sink Sterilizer Soda Disp Wtr Sewer Mtrs
Whirlpool Sump Pump F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory 1 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 1 Gar Drain Plaster Sink Dip Well Comm Ice Maker
Dishwasher 1 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 Interior plumbing alterations at Room #217.
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1608640200
Valuation ,000.00 Plan Approval $0.00 Permit Fees $35.00 ❑ 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 08:42 9202311289 3 RASMUSSEN PAGE 01/01
City of Oshkosh
Insp
.. ction SerViCe5.11v151on
POlbox 1130
Oshkosh, WI 54903 -1130
Ph4e: (920) 236 -5050
F'axl (920) 236 -5084 0.11-11Q/1-1
cmi TI-yr WATER
Plumbing Permit Application •
• 1 h 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(e) 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 S100.00 phis the normal permit fee, which
lever is greater.
OR
If vbu are a_gatttraaror ar ', • .' - in the _ r 4oynt IFtattent and have adeatgtgf�nds. check h,¢r
•
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a* Advisory - For applicable projects, an Electrical Installation Verification (;HIV) firm, signed by the Electric
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications sabnnitted without an EIV when such is regrind, will not be
processed for Penult Issuance and w1fll be returned fur completion.
.Address / 0 ✓. Wes[{�i:(A Value S'D , °
Job �
._._.. �..._.. (Enclndin¢ labor and ntatetrial�)._, - Date / 2 —Z y --i
Owner _ 5 vxr 11`0-.4,0 Contractor t RA S 1 14. u .. S, ru P 1 1 , Sr C r
❑SineeFamil []Dnplet IMulti- Fataiiyr [Naomi I:Commelrcial °Industrial
Number of Futures: .
Bathtub Sump Pump ..—._-_, Planter Sink — Ranf Drain --
SI over < <_ San. Sump/Pnmp _ Scullery Sink __ dada lisp __ ---
Whirlpool _._ Winer Softener - Service Sink _ _ Coffee Mkr '
Lavatory .— f _.. Smntdpipe Rec .«.,......y. Shamp Sink __.._,., Site Drain `...___
Toilet Gamlgc FI) Surgeons Sink _ Waits Stn
Kit Sink — I [
.Heal Waste Sterilizer l
,__... -... cc (heat _
Disposal _ Fier Sink — .,,. RPZ Valve —_ l omm Ice Makes _
Dishwasher . - „ Bred= Sink ___ Bidet intGr m Trap
Moot iDrain Clnsvtn Sink _ 1Jrinal Ext (}, c Trap _
Floe Bibb _ Exam Sink Beer Tap _ Eye Wa 1t Stn
Muer Hester F Prep Sink Dripper Well ------ .Deduct Meter _._..
:I Gas Ll Elect r.1 Pwrvm Floor Sink _ Drink Fnm -- wtr Sewer Mt — ,�._
Clotho Wshr - Hand Sink Wash Fgtn Ar w „_ Wtr tJynge Mtr
T.ndry Tray tab Sink Creek 1? int
Mine Fixtures
FJcct1'ic Contractor (for pr. of not requiring an EIV Form)
Use / Nature of Work r'°-P.1a e -et Q,o o ' oZ ( 7
- - -- � .- _ r____ Sine Material — Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
•
06/Qq
•
Received Time Dec. 27. 2010 8:23AM No, 4179