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Home My WebLink About2011-Plumbing #114 CITY OF OSHKOSH No 144649 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 425 N WASHBURN ST Owner SHORELAND DEVELOPMENT CORP Create Date 01/10/2011 Contractor D.R. HANSEN PLBG. Category 442 - Commercial- Interior (New /Relocated Fixti 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 2 San Sump /Pump Flr/Wst Sink Bidet Site Drain Misc. Toilet 2 Water Softner Hand Sink Urinal 1 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 1 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 Pommerening / Add men's bathroom. ** **Water calculation worksheet is required to be submitted prior to RI of Work inspection* ***debit acct Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcel Id # 1615060000 Valuation $5,000.00 Plan Approval $0.00 Permit Fees $42.00 ❑ Permit Voided Issued By 1 Date 01/14/2011 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. 01/10/2011 09:26 19202337466 DR HANSEN PLUMBING PAGE 02 City Oshkosh Inspection ion Services Division . 1' OBox 1130 Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 • Fax: (920) 236 -5084 • ON ATE R 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 1128, Oshkosh WI 54903-1128. Commencing work without permit(s) will tesult In foes being doubled or $100.00 plus the normal permit fee, which ever is greater. OR I ou c k co tractor •artici I t e _. ermit Fe , , . A to and h , 1 _ . ' :ate u . d , - k here if you want this ororissed through your account f " 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 wbaa such is required, will not be processed for Permit Issuance and will be returned for completion. Job Address 4.- - 1 is l . A * Value (Including tabor cad meoerials) 00 Date J ' 1 0 -(/ Owner . .e d ._,„„ Contractor A ? i‘ , ,J ;, ['Single Family []Dup QMultl- Family ['Rental P i mmerciai DIudetstrial Number of Fixtures: Haclmrb Sump Pimp Pies Plaster Sink Roof Shower sae Sraop/1'+eap Scullery Soak Soda Dim Whirlpool Water Softener Service Burk Coffer Mbr Lavatory a Standpipe Roc Shaw Sink Site Dram Toilet Gauge FD Surgeons Sink Wailes Stu Kit Suck Lard Wens Seemlier is Cheat Disposal Bar Sink RPZ Valve Comm Ice Maker Dishwasher Hrealkrm Sink Bidet Int Greene Trey Floor Drain Class= Sink Urinal _J_- Bit &ease Trap Rose Bibb Rum Sink Bar Tap Bye Wash Stu w1t nearer F Prep Sick Dipper Well Deduct Meier 0 ea. 0 Elect o PMrV t Floor sioatk Dunk Fnm � Wtr S ewer Mtr Clothes Wshr Hind Side Wash Fate Wt usage My Lofty Tray Lab Sink Catch Basin Misc nouns Electric Contractor (for projects not requiring an EIV Form) Use / Nature of Work A 9 , ...S irooM Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Received Time Jan. 10. 2011 9:45AM No. 4312 06/09