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Home My WebLink About2011-Plumbing tilij CITY OF OSHKOSH No 145085 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 3001 S WASHBURN ST Owner BFO FACTORY SHOPPES LLC Create Date 03/07/2011 Contractor KELDERMAN PLUMBING Category 442 - Commercial- Interior (New /Relocated Fixti Plan Bathtub Clothes Wshr Classrm Sink Surgeons Sink Shower g Roof Drain Deduct Meters Lndry Tray Exam Sink Sterilizer Soda Disp P 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 Toilet Site Drain 1 Misc. 1 2 Water Softner Hand Sink Urinal Fixtures Kit Sink Wait. St. Standp Rec Lab Sink Beer Tap P Ice Chest Dis P Gar Drain Plaster Sink Dip Well P Comm Ice Maker Dishwasher Local Waste Scully Sink Drink Ftn 1 Int Grease Trap Floor Drain 2 Bar Sink Sery Sink 1 Wash Ftn Ext Grease Trap Hose Bibb Breakrm Sink Shamp Sink Catch Basin Water Heater 1 Drink Dispenser Eye Wash Statn Use /Nature Coach (E050) / Tenant build out from 1 restroom to 2 restrooms, DF and SS. A water calculation worksheet is required of Work prior to rough -in inspection. Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcel Id # 1329420000 Valuation 5 0.00 Plan Approval $0.00 Permit Fees $77.00 11 Permit Voided Issued By Date 03/08/2011 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 an ce .ary approvals before starting such activity. Signature[ ` Date 3 -.-1/ Agent/Owner Address N9679 STATE PARK RD, SUITE 112 APPLETON WI 54915 - 0000 Telephone Number (920) 450 -5398 (cell) 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 of Oshkosh 1 Inspection Services Division P O Box 1130 Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 Fax: (920) 236-5084 ON Plumbing Permit Application THF WATFR 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 1 ou are a contractor sartici.atinf in the Permit Fee Account S stem and have ade•uate unds check here i ou want this processed throu h your account n ** Advisory - For applicable projects, an Electrical Installation Verification Contractor or Homeowner (for installations allowed to be performed by the homeowner) by the Electrical er) 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 3049/ S. 426'6.4L"."4 S>' , Value (Including labor ) , _ n a bor and materials) / 5 r�(' 7 / Owner �4c�' �v 50 Date g C / s Oa- Pt Contractor • ' &-" e1•7 ['Single Family ❑ Du lex "' li''� '�� P ['Multi-Family ❑Rental Commercial II ndustrial Number of Fixtures: Bathtub Sump Pump Shower Plaster Sink San. Sump /Pump Roof Drain Whirlpool Scullery Sink Water Softener Soda Disp Lavatory a - Service Sink ___L___ Coffee Mkr Standpipe Rec Toilet Shamp Sink Garage FD Site Drain Kit Sink Surgeons Sink Local Waste Waitrs Stn Disposal Sterilizer Bar Sink Ice Chest RPZ Valve Comm Ice Maker Dishwasher Breakrm Sink Bidet Int Grease Trap Floor Drain Classrm Sink Urinal Hose Bibb Exam Sink Ext Grease Trap Beer Tap Eye Wash Stn Water Heater 1 F Prep Sink Gas!(Elect'_ PwrVnt Dipper Well Deduct Meter Floor Sink Drink Fntn —L Clothes Wshr Wtr Sewer Mtr Hand Sink Lndry Tray Wash Fntn Lab Sink Wtr Usage Mtr Catch Basin Misc Fixtures _i____ Electric Contractor (for projects not requiring an EIV Form) Use / Nature of Work � p ri-fr • r x r57`,:� O <n f °Z e Si o sus,., S Size Material Type # Conn. Type Sanitary Sewer 9 #v6-- ‘ Xrs f,�, j /�� Storm Sewer / Water Service 41 cti . CX, S f;H 5 o11 x 06/09