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CITY OF OSHKOSH No 144670
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 303 W SOUTH PARK AVE Owner BRIAN S /ANGELA L BISHOP Create Date 10/07/2010
Contractor J RASMUSSEN PLUMBING INC Category 412 - Res - Interior (New /Relocated 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 1 F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory San Sump /Pump Fir/Wst Sink Bidet Site Drain Misc.
Toilet Water Softner Hand Sink Urinal Wait. St. Fixtures
Kit Sink Standp Rec 1 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 SFR / City rehab / Install drain hook -up for washer in basement, correct waste line violation, repair existing toilet, and
of Work install sump pit with pump and remove connection to floor drain.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0904240000
Valuation 1,500.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By eD Date 01/18/2011
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 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.
in 01/18/2011 arectl Servl r C� 06:fllv59 ) ; 9202311289 J RASMUSSEN PAGE 01/01
City of Oshkosh
1 .
P O'T3ox 1130
Oshkosh, WT 54903 -1130
Phone: (920) 236 -5050 ,I
Fax_ (920) 236 -5084 OJ I _
0.* THE vot R
Plumbing Pemmlt Application
1 hereby apply for a permit to do and install the fallowing plumbing on Me 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_
• iApplecation(s) and fee(s) can be brought to City Ball, Room 205 or mailed to Inspection Services, PO Box 1128. Oshkosh WI
154903 -1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the normal permit fee., vyhidi
ever is greater.
OR
>r a 4 ‘ c a r a .'c . , ', . n A errs; T a Acepunt Svsr dhaua acila jaEds„ ac kera
ifxe�..'t1A tis-•p°-e ,se4 ,t.()r rt nr 4cotett.l_., ,
" Advisory - For applicable projects, an Electrical Installation Verification (EIV) foam, signed by the Electrical
Cnntmetoar or I:iomeowner (for installations allowed to be performed. by the homeowner) must be submitted
with the permit application, Applications submitted. sailboat an EIV whets such is regxiored, w#U not be
!processed for Permit Issuance and will be rcta rtied for completion- ` — �7r /1
3°3 W• S, e 1k x k Va (Tnetudina Ia1,or Rud m itterratr) is 0 0, 0 0 Data
Job Ad.drevs
Q w n e r s ' e k a{ Contractor �t R. 0.S 4 4 . u 4 4 . % , , J 2 eN P 11 r 2 C ,
l� 1
`;Single Family ❑Duplex DMnld- Family • DRental DCommercial Ellodustriai
Number of Fixture/4: _.ti__
Bathtub -- Su mp Pump 1 Plater Shtk .._ -- Rtw1f Drain
Shower S. Sump/Pump tddlory Sink —_�.,_ Sochi Dino — ...._.
Service Sink Coffee Mkr ---
?Whirlpool ,,_— Water .4oRaner __._.._ , —"'�.
Lavatory Standpipe Roc Sham) Sink -- Sire Drain
Tnild ��-
Garage C'[) Surgeons Sink —_. Wain Sn� ---
Kit Sink
Loral Waa c Stcrlliz'r Tee Chest
13nr Sink RP7_ valve Comm Tee Maker .
Arcnkm Sink _ —..,., R 4et 1nt(r a Trap _—
Awltivacha Urinal Ext ( T -
Floor Drain Gleason Sink _
EOM Sink _,_ -� liner Tap ,, 13yr; Wash Stn
PttRe Bibb Tkdtict Metier r—
water Hader _.
F Prep Sink - . Dipper Well __
1.1 Gas 0 t ticct 0 Pwriinr Floor Sink Drink Pntn Virr Sewer Mtr
Clothes Wehr __ Fland Sink Ww4i Finn WV Usage Ma' ---
1.ndry Trap __ _ Lab Sink _ �,_ Cateh Basin Mile le Fixtures -----
Electric Contractor (for projects not requiring an EIV )Form) .,,
a 1- r e L � 6 c�° ` - �/ .lip 6 rocf� ♦ --p
I:ise / Nature of Work � . t '
— —�_ Size Material Type # C onn. Type
Sanitary Sewer
Storm Sewer
Water Service
..
Obl09
Rece T Jan. 18. 2011 6:40AM No. 4398