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Home My WebLink About0145215-Plumbing g) CITY OF OSHKOSH No 145215 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 3885 SHOREBIRD CT Owner ANDREW UMARGARET M PERRIE TRUST Create Date 03/22/2011 Contractor KOCH PLUMBING Category 410 - Residential- Interior 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 1 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 / Finish basement bathroom. **debit acct of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcel Id # 1281350000 Valuation $1,200.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided Issued By 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 2005 DOTY ST OSHKOSH WI 54902 - 7040 Telephone Number 920 - 231 -6661 or 235 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. I RO M :John - Karolyn >KOCH PLBG & HTG FAX NO. :920 231 6661 Mar. 21 2011 10:54AM P1 City of Oshkosh Inspection Services Division P 0 Box 1130 e 411.'111 ) Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 Fax: (920) 236 -5084 QIHKOfH 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 5100.00 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 (1 • ** Advisory - For applicable projects, an Electrical Installati 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 39I S4: f Q� Value (Including labor and materials ' ZQC 2 ° . /, Date .7/2//// to Owner gager) In Contractor t A 4 I ./`j9 1- /4 ,,,44G . [ Duplex ❑Multi -Family Single Family Dl Y ❑ Rental ❑Comrrferesal J ['Industrial Number of Fixtures: Bathtub Sump Pump Plaster Sink Roof Drain Shower San. Sump/Pump Scullery Sink Soda Disp Whirlpool Water Softener Service Sink Coffer Mkr Lavatory ,—Y_ Standpipe Roc Shamp Sink Site Drain Toilet —_, Garage FD Surgeons Sink Waihs Stn Kit Sink Local Waste Sterilizer Ice Chest Disposal Bar Sink RPZ Valve Comm Ice Maker Dishwasher Brealam Sink Bidet Int Grease Trap Floor Drain Classrm Sink Urinal Ext Grease Trap Hose Bibb Exam Sink Beer Tap Eye Wash Stn Water Heater F Prep Sink Dipper Well Deduct Motor ❑ Gas ❑ Elect ❑ PwrVnc Floor Sink Drink Friel Wtr Sewer Mtr Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr Lndry Tray Lab Sink Catch Basin Misc Fixtures Electric Contractor (for projects n ot requiring an EIV Form) 4 Use / Nature of Work t7.-7, 5 5 ,,,,, s - s Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Received Time Mar. 21. 2011 10:43AM No. 5012 06/09