HomeMy WebLinkAbout0145694-Plumbing till CITY OF OSHKOSH No 145694
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1260 N WESTFIELD ST Owner ELIZ B DAVIS CHILDRENS HOME Create Date 05/02/2011
Contractor M P KELLY Category 442 - Commercial- Interior (New /Relocated Fixti Plan
Inspector Paul Wolf
Bathtub Clothes Wshr Classrm Sink 2 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 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 2 Bar Sink Sery Sink Wash Ftn Ext Grease Trap
Hose Bibb Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn
Water Heater 1
Use /Nature Interior plumbing for classroom addition. * *A water calculation worksheet is required prior to rough inspection **
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1608600000
Valuation % $$44 00.00 Plan Approval $0.00 Permit Fees $42.00 ❑ Permit Voided
Issued By �. / Date 05/03/2011
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 665 N MAIN ST OSHKOSH WI 54901 - 4431 Telephone Number 231 -1750
To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of
Inspection (Le. 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.
'ofOshkosh M: P. K INC. •
•ection Services Division al
665 N. MAIN STREET
Box 1130
lcosh, WI 54903 -1130
- OSHi(OSH ASC. 54901
one. (920) 236-5050 94 -AV •
(920) 236 -5084 ON T E ATER
• • Plumbing Permit Application
ereby apply
for a pen nit to do and install the fbllbwing plumbing on the premises hereinafter described, the work to conform to the •
Wisconsin State Plumbing Code, in the performance of which all patties hereto agree to and are bound by said statutes.
City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI •
Application(s) and fee(s) can be brought to
54903 -1128. Commencing work without P ermit(s) will result in fees being doubled or $100.00 plus the normal permit fee, which
ever is greater. . •
OR • n em a d have �e A nuts und chec here
ou ar' a contractor , Id , ,t n' in ,e -' rii t ee 1
ou want t is • roa: sseii roue h ,u ' c, u t • .
'so applicable projects, =Electrical I ntst�al4tion Verification (EEV) form, . signed by the Electrical
Advisory - Fo
mtr'"t'rliemeovt'tler (for instaliStteMintlit4edttiteperfordic.d byt1IelhomeoWner) must besubmitted
ith the permit application. Applications submitted witlinutanEIV.whensuchis required, will not be
ocessed for Permit : seance and will be returned for 'completion. 1
caner ,..1) � �
• e laborandmaterials)
46/ ° ` Date
43 Address I a C ► e� f..- �Valn �
c C 6 ontractor "1 & ..P dLL' J4/L _ �, � .. • Industrial
[]Multi Family. . .,ORenta C om m ercial ❑
]Single Family ['Duplex
umber of Fixtures: Roof Drain
S Pump Plaster Sink �–
.hower San Sump/Pump b Scullery Sink Sofia Disp .
showe Softener S Service Sink i
Water o
Vhirlpool ampSink Drain
_ Site ,avatory Standpipe Rea Sh Site D Stn
Surgeons Sink
'oilet _l___ UarageFD .Sterilizer ,Ice Chest
;it sink Local Waste --'T Comm Ice Maker
Bar Sink RPZ Valve
)isposal � Bidet IntCireaseTrap
)ishwasher $reakan Sink �'— Bxt (}reuse Trap
Classna Sink Urinal
� By
wash Stn
lour Brain Beer Tag
lose Bibb Bum Sink •
F Pre Sink Dipper W l --'l i ' ":
Vater Rego DrinkFatn Wtr SewerMtr
0 Gas 0 Elect oVnt Floor Sink Wtt Usage Mt ;lothes Wshr Hand Sink wash Fnht _ - _ __ .
- - - ' Miser Fi�turas
ndry Tray Lab Sink Catch Basin .
ic Contractor (for projects not requiring an EIV Form) .
Nature of Work
Size
Material Type # ' . ' Conn. Type
Sanitary Sewer
•
Storm Sewer
' . . 6 0 :
Water Service
•
• • • 4 ik %
•
. .
. .
. .
• . . 0 6/09
• . . .
. .. .