HomeMy WebLinkAbout0144741-Plumbing (sink & disposal) e ol CITY OF OSHKOSH No 144741
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1040 N WESTFIELD ST Owner EVERGREEN VILLAGE Create Date 01/25/2011
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 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 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 #314 / Replace kitchen sink & disposal. * *debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1608640200
Valuation $800.00 Plan Approval $0.00 Permit Fees
$25.00 ❑Permit Voided
Issued By 0)73.(,,0 Date 01/25/2011
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.
01/25/2011 08:58 9202311289 J RASMUSSEN PAGE 01/01
City of Oshkosh
In ►ection Services tllvlsion
F 013mt l t 30
Oshkosh, WY 54903 -1130
® .
Phone: (920)236-5050 '
Fax; (920) 236-50S4 Oil KO
ON IF4F WATER
Plumbing Permit Application
1 hcireby Apply for a permit to do mtd install the following plumbing on the premises hereinafter dcieribcd, the work to conform to the
Wisconsin State Plumbing Code, in the performance of which all patties hereto agree to and ate bnni,d by said statutes.
* Application(s) end fce(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1125, Oshkosh WI
54903 -1128. Commencing work without permit(s) will result in feat being doubled or 5100.00 plus the normal permit fee, which
ever is greater.
OR
If vim ars e a on s r aj.pr n rticln tg in she Permit e , 1,1 tc a. , c tr t_r/Rat/ate funds, citok here
if vq34, Irani this_j rjcc.v.sed rhrc►ugh your accout E .
** Mdvllsomy - For applicable projects, an Electrical Installation Verification (EIV) foam, signed by the Mewled .
Cmntxactor or Homeowner (for installations allotted to be performed by the homeowner) must be submitted
witb the permit application- Applications snbtnitted without an EN when such is required., will not be
processed for Permit Issuance and will be renamed for completion.
0e.
Job Address 16Y.,9 P. W4 .1 !' •e,L� VaMue (Inciudins labor and mateariali) 0 t Date ) '•Z / //
Owner L; // Contractor .t J 1.5 n t t s S , e P 1 G I T r' c
I:Siingle Family ( Duplex M uni- Family Cliental DCominerciai D]n ial
Number of Fixtures:
Rathtrrfi --- -,••,- Sump Pump Pla9tcr Sink — ,,,,,,,_ Roof Drain
Shower _ —• -•• Son, Sump/Pwnp Scullery Sink Softy Dap
Whirlpool Water Softener _ �. ,, Service S ink Coffee Mkr _
lavatory Standpipe Rec — _ Shame Sink Site Drain • •
Toilet _ (ke r FD Qurgcans Sink. �•_• • Waits Stn ,__ ,,._
Kit Sink _ Local Wean • Sterili�nr ice Chest
Dioposol � 2.. Ror Sink --- RP7_ Val Comm lac Maker ,_ _
Dishwasher — 13reakrm Sink Bidet Mt Suave 'imp
Floor Drain ,,,,•_ Ctna+rm Sink Urinal 8x4 Grease Trip
Hose Bibb Exam Sink _,,,,,,,, -„ Beer Tap ____- nye Waeh Stn
Water Heater ., Prep Sink Dipper Well Dretrct Meter
t: i (krs n cs Blear I Ptveli t 1 Floor Sink Drink Pnm �.. _ Wtr Setter Ws
Clothes Wshr Hand Sink ,, _ Wash Pntn —�_ Wtr Usage Mtr -„_
1.ndry Tray _ •� lab Sink _ Cahn Basin - �_.� Mine' e _
Electric Contractor (for projects not requiring an EIV Form) L -
Use / Nature of Work A PAL, 3 / / F• � IA K >L/ O t.,.. f i A. rC L
Sizc ~ — — Material Type # ...__ Coon- Type
Sanitary Sewer
Storm Sewer
Witter Service
oh /oP
Received Time Jan. 25. 2011 8:40AM No. 4481