HomeMy WebLinkAbout0144629-Plumbing (laterals) (&) CITY OF OSHKOSH No 144629
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 601 OREGON ST Owner KIN LLC Create Date 01/12/2011
Contractor D.R. HANSEN PLBG. Category 444 - Commercial - 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 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 Repair water service.
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service Lateral 1 Repaii
Parcel Id #
0900080000
Valuation , 00.00 Plan Approval $0.00 Permit Fees $50.00 ❑ Permit Voided
Issued By Date 01/12/2011
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.
01/12/2011 08:29 19202337466 DR HANSEN PLUMBING PAGE 02
City of Oshkosh
Inspection Services Division
P 0 Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 OTL:�OTl:
ON THE WA
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 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 $100.00 plus the normal permit fee, which
ever is greater.
OR
1 ou are a contra • r • artici , atin - in th _• rm t count S ste c , h u • , , 'u , t _ , _ . ,
if you want this processed through your account
" Advisory - For applicable projects, an Electrical Installation Verification (ETV) forest, signed by the Electrical
Contractor or Homeowner (for installations llations allowed to be performed by the homeowner) mast 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. C Job Address ( )fenon J^{-. Value (Including Labor and n>arc al) 0 D, . Date 11 la `1 I
Owner 1. O re} WWhlots 'I rl Contractor D 1i. I4Ar1y 'Ph .inh 11.P
-
['Single Family QAaplex [JMulti -Farm o �
ly �• [commercial DIndastrW
Number of Fixtures:
Bathtub Sump Fungi Plaster Sink gp,aia
Shower sae. Sump/Pump
Scullery sink Soda Dsp
Whirlpool Water Softer Service Side Coax Mks
Lavatory Standpipe Rec Stomp Sick Site Dram
Toilet Gi lac FD
Surgeons
Kit Sink sot Waits sm
Local Waste Sterilizer Ice Chest
Bar Sink RP2 vitae
Dishwasher Breakcm Sink Conan lee !Weber Bidet Int Grate Trap
Floor Drain Classrm Sink Urinal Bxt Grease Trap
Hose Bibb Exam Sink Bea Tap By e Wash Sin
Water Heater F Prep Sink Dipper Well Deduct Molex
O eras 0 Elect 0 Pwrvpt Floor sink
Drink Faro Wtr Sewer Mtr
Clothes Webs Head Sink
Wash Pam wv M ar
Lndry Tray Lab Sink Catch Basin
l�fiac Fbthoea
Electric Contractor (for projects not requiring an EIV Form)
Use / Nature of Work "'Repair (p* r c. r v i C
Size Material Type # Conn_ Type
Sanitary Sewer
Storm Sewer
Water Service
Received Time Jan. 12. 2011 8:48AM No. 4340 06/09