HomeMy WebLinkAbout0144938-Plumbing 0 CITY OF OSHKOSH No 144938
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 935 MOUNT VERNON ST Owner RICHARD A BOESE Create Date 02/18/2011
Contractor HOMEOWNER Category 412 - Res - Interior (New /Relocated Fixtures) Plan
Bathtub 1 Clothes Wshr 1 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 1 San Sump /Pump Flr/Wst Sink Bidet Site Drain Misc.
Toilet 1 Water Softner Hand Sink Urinal Wait. St. Fixtures
Kit Sink 1 Standp Rec 2 Lab Sink Beer Tap Ice Chest
Disposal Gar Drain Plaster Sink Dip Well Comm Ice Maker
Dishwasher 1 Local Waste Sculry Sink Drink Ftn Int GreaseTrap
Floor Drain Bar Sink Sery Sink Wash Ftn Ext Grease Trap
Hose Bibb 2 Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn
Water Heater 1
Use /Nature LATE PERMIT/ Interior plumbing remodel to include new fixtures and repipe. Work covered prior to permit issuance
of Work and rough inspection. Owner Richard Boese has stated he owns and occupies the residence.
•
Size Material Type # Conn. Type
Storm Water
Parcel Id #
1001830000
Valuation $2,600.00 Plan Approval $0.00 Permit Fees $77.00 ri Permit Voided
Issued By �J
Date 02/18/2011
The undersigned, in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the
principle residence of the undersigned, hereby acknowledges, per Wisconsin State Statutes, ss 145.06, that other individuals
will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing
the work involved must be covered by a permit issued to a properly licensed Master Plumber.
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
Signature Atiaflpe e Date ").-r (Q-1
Agent/Owner
Address 916 GEORGIA AVE OSHKOSH WI 54902 0000 Telephone Number
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.
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.
City of Oshkosh
Inspection Services Division
PO Box 1
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050 L
Fax: (920) 236 -5084 Of HKOf H
ON THE WATER
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
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account fl
** 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 when such is required, will not be
processed for Permit Issuance and will be returned for completion.
Job Address 8 135 411.t... •Je 1AcDn Value (Including labor and materials)7..0 , 1
1
Owner Ric All 6.1 . ese- Contractor O
,ingle Family ❑Duplex ❑Multi- Family ❑Rental ❑Commercial ❑Industrial
Number of Fixtures:
Bathtub 1 Sump Pump Plaster Sink Roof Drain
Shower San. Sump/Pump Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Coffee Mkr
Lavatory _A__ Standpipe Rec Shamp Sink Site Drain
Toilet _1— Garage FD Surgeons Sink Waitrs Stn
Kit Sink 1 Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher 1 Breakrm Sink Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trap
Hose Bibb X- Exam Sink Beer Tap Eye Wash Stn
7 a r Heater / F Prep Sink Dipper Well Deduct Meter
Gas ❑ Elect ❑ PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr / Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Electric Contractor (for projects not requiring an EIV Form)
Use / Nature ofWork 'P1 v b,og1 i q , e;..r ('e Mele l
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
06/09