HomeMy WebLinkAbout0146571-Plumbing (hose bibb) CITY OF OSHKOSH No 146571
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 215 WAUGOO AVE Owner WINNEBAGO COUNTY Create Date 06/28/2011
Contractor WINNEBAGO COUNTY Category 445 - Commercial - Exterior Other Plan
Inspector Rich Wood
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 1 Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn
Water Heater
Use /Nature Installation of freezeless hosebibb exterior. ck #395991
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0200250000
Valuation $400.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By Date 06/28/2011
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 h - - t. se 4e any necessary approvals before starting such activity.
Signature `, l
� Date A4 (,,
i i
Agent/Owner
Address 6, E CTY RD Y OSHKOSH WI 54901 - 9775 Telephone Number 232 -1962
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
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 I
ON TH 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 $100.00 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 f
** Advisory - For applicable projects, an 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. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
Job Address 04.5 no 0o Value (Including labor and materials) °L ,—
S Date Ci2/
Owner t.9u6 a 4 rer eov. o'r` Contractor Co v.sr R o L Z c rb e e„0. i
❑Single Family ['Duplex DMulti-Family DRental YCommercial ❑Industrial
Number of Fixtures:
Bathtub Disposal Drink Ftn Catch Basin
Whirlpool Dishwasher Wait. St. Wash Ftn
Lavatory Sump Pump Ice Chest Urinal
Toilet Ejector /Grind Exam Sink Gar Drain
Res. Sink Water Softner Sculry Sink Soda Disp
Bar Sink Local Waste Hand Sink Coffee Maker
Water H ter Clothes Wshr F Prep Sink Comm. Ice Maker
❑ Gas Elect PwrVnt Bidet Sery Sink Site Drain
Shower Beer Tap Int Grease Trap Roof Drain
Floor Classrm Sink Ext Grease Trap Standp Rec
Lndry y Surgeons Sink R.P.Z. Valve Eye Wash Stn
Lab Sink Breakrm Sink Shamp Sink Wtr Sewer Mtrs
Plaster Sink Dip Well Flr/Wst Sink Deduct Meters
Sterilizer Hose Bibs / Wtr Usage Mtrs
Misc.
Fixtures
Electric Contractor (for projects not requiring an ETV Form)
Use / Nature of Work 3 A As, 'Le. 4a. t2..
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
07/07