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Home My WebLink About0145079-Plumbing (water damage) Il CITY OF OSHKOSH No 145079 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 617 GROVE ST Owner SALLY MILLER Create Date 03/07/2011 Contractor KEYES & SONS PLUMBING Category 420 - Residential -Other 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 Repipe water distribution and DWV piping in home due to water damage. of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcel Id # 1103900000 Valuation $5,500.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided Issued By Date 03/07/2011 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 PO BOX 960 NEENAH WI 54957 - 0960 Telephone Number 725 -2494 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. City c xi cn Services Inspection Srvices Division P Box 1130 Oshkosh, WI 54903 -1130 ( 4.11- III- Phone: (920) 236 -5050 Fax: (920)236 -5084 .1 • Plumbing Permit Application I hereby apply for a permit to do and install the following plumbing on the premhes 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 Bali, Room 205 or mailed to hnspecdon Services, PO Box 1128, Oshkosh WI 54903 -1128. Commencing work without permit(s) will result in hes being doubled or 3100.00 plus the normal permit fee, which ever is greater. OR If you are a contractor oarticIpattn2 to the Permit Fee Account SystepLand have adequate funds. check hers if you want this processed through your account fl a" Advisory - For applicable projects, an Electrical Installation Verification (EIV) form, signal 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 ETV when such is required, will not be processed for Permit Issuance and will be returned for completion. CV (D r Job Address �� ``"" iV� SF (r Value .awatns 'abound nstnri.te) � (7 E r Date .313 /r 1 Owner Vh t f t e Contractor Key e, 4 Sb Y 1 1-- Single Family � uplex OMulti -Famlly []Rental QCommercIal DL (ti strial Number of Fixtures: Bathtub • Sump rump Plaster Sink Roof Dada skewer sae. Sump/hump Smiley Sink Sods Disp Whirlpool Water Softener Service Sink Coffee KW Lavatory Standpipe Rec shoe p Sink She DmM Toilet Osage PD Surgeons Sink Waive Sur Kit Sink Local Watt Steriliser tee Chest Disposal Bar Sink RPZ valve Caws tee Maker Diahwashcr Brea rm sink Bidet Lu Oman tip Moor Dnia Chasm Sink Urinal En Orcw Trap , Aria Bibb Exam Sims Beer Tap Bye Wash Stn Water Heater P Prep Sink Dipper Well Deduct Mete 0 Oa 0 Bleat 0 PwrVnt Floor Sink Drink Prue Wtr Sewer Mtr Clothes Weir Hand Sink Wash Pntn Wtr Unix Mtr LndrY Tray Lab Sink Catch Baia Mien Fixtures Electric Contractor (for projects not requiring an EN Form) , Use / Nature of Work Al 1 . t CO V ,L. i n ,, i it" W t L! i • + • Size Material 'Type a Conn. Type Sanitary Sewer Storm Sewer • Water Service 06/09