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Home My WebLink About0145210-Plumbing (bathroom remodel) ila) CITY OF OSHKOSH No 145210 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 2065 HICKORY LN Owner MICHAEL H /PATRICIA L SCHUMERTH Create Date 03/22/2011 Contractor J RASMUSSEN PLUMBING INC Category 410 - Residential- Interior Plan Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters Shower 1 Lndry Tray Exam Sink Sterilizer Soda Disp 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 Site Drain Misc. Toilet 1 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 SFR / Remodel master bath. *"debit acct of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcel Id # 1526180000 Valuation $3,800.00 Plan Approval $0.00 Permit Fees $28.00 ❑ Permit Voided Issued By a/Y/f/l/ Date 03/22/2011 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement holder(s) and to secure any necessary approvals before starting such activity. Signature Date Agent/Owner Address 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 8887 Telephone Number 920 - 231 -1289 To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may continue if the inspection is not performed within two business days from the time the project is ready. 03/22/2011 Inspection Services 06:21 Division 9202311289 3 RASMUSSEN PAGE 01/01 City of Oshkosh P'O Box 1130 Oshkosh, WI 54903-1130 Fam e: (920) ) 23(508050 011-140./H .Fax: (920) 23fi50$�1 ON 11-4 WATER Plumbing Permit Application I hereby apply for a permit to do and install the following plumbing on thc premises bereinafler described. the work to conform to thc Wisconsin State PitUnbing Code, in the performance of which all parties hereto agree to and arc 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 W1 54903 -1128_ Commencing work without permit(a) will result in foes being doubled or 5100.00 plus the normal permit fee, which over is greater. OR. 1 v are c nt tor ,partic'j t „e )fM.� the Permit ,F' AccountSy_t n gad ' adeauate funds ghec,i hers _f Vey �� ac ify_a -want tIij pL ' s.,s ed throu .zh y >� u ac(ount ^k* Advisory - For applicable projects, as 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. Application submitted without an ETV when sack is reguired, will not be processed for Permit IsSIIIMIT.t and will be retained for completion. t- u M'J 3 0 , _. Date ? -21-1/ Job Ad.dress. 0 b I .1 at 1 Value (Including labor and materials) Owner • ccLkt& wk P.r • Contractor , , o�SLu S S .ex P 11 r IT" [Ingle Family Dbnplex Multi- Family ❑Rental ❑Commercial []Industrial Number of Fixtures:: Bathtub _._ Sump Pump Piaster Sink Roof Drain _-- Shower • t* Smr. Sump/Pump ---- Scullery Sink -- -- Soda T)isp - , — Whirlpool _ ' Water Softener Service wink _ Coffee Mkr M lavatory - Standpipe Bee --- Shama Sink Site Train (love pp „ A ,__ — Surgeons Sink Waite Stn - - - - -- Toilet _ _ • Kit Sink _— Ln a1 Waste _�„ .. Sterilizer _, - -- Ice Chest __, Bar Sink ItPZ Valve Comm Ice Maker — -- Di appeal - _ ... - -�.... Dishwasher Brcalu r "-- m Sink Bidet Int Grosse Trap (:iar+srm Sink Urinal Ext Oresac Trap _.. Floor Drain , Exact Sink _ Deer Tap ---- Eye Wash Stn HIM pith Deduct Mcwr Water HOW F Prep Sink _. --- Dipper Well -_—_ - -- t Gist 1.1 Elect Ir PtviYat 'Floor Sink �_ Drink Finn Wtr ,Sewer Mfr . -.- Clothes Weill' _ Hand Sink Wash Fntn We Usage Mtr _ — Leh Sink Catch Basin Mize Fixtures .,. .4ndry Trey . � —_ ..,— Electric Contractor (for projects not requiring an ETV Farm) ----- Use 1 Nature of Work 01. Pei Lr to Dt (1.4,1.-.0 Lt _______—.. Size Material ~— _W..- Type # Cann. Type Sanitary Sewer Storm Sewer Water Service 06/09 Rece Time Mar. 22. 2011 7:03AM No. 5017