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Home My WebLink About0149185-Plumbing (addn to #148792)0 CITY OF OSHKOSH No 149185 OSHKOSH ON THE WATER Job Address 2163 W 9TH AVE Contractor GERRITTS PLUMBING INC Inspector Jerry Fabisch PLUMBING PERMIT - APPLICATION AND RECORD Owner THOMAS O /PATRICIA HALLQUIST REV TRUST Create Date 02/08/2012 Category 442 - Commercial- Interior (New /Relocated Fixti Plan Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Shower Lndry Tray Exam Sink Sterilizer Soda Disp Whirlpool Sump Pump F Prep Sink RPZ Valve Coffee Maker Lavatory San Sump /Pump Flr/Wst Sink Bidet Site Drain Toilet Water Softner Hand Sink 2 Urinal Wait. St. Kit Sink Standp Rec 1 Lab Sink Beer Tap Ice Chest Disposal Gar Drain Plaster Sink Dip Well Comm Ice Maker Dishwasher 1 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 of Work Valuation $7,872.00 Issued By Size Material Type # Conn. Type Sanitary Sewer Stone Sewer Water Service Plan Approval $0.00 Permit Fees $28.00 ❑ Permit Voided'i 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 Deduct Meters Wtr Sewer Mtrs Wtr Usage Mtrs Misc. Fixtures Parcel Id # 1311840000 Date 02/09/2012 Agent/Owner Address 709 W DEERVIEW DR APPLETON WI 54913 - 9677 Telephone Number 920 - 739 -1399 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 Sump Pump Inspection Services Division Plaster Sink P O Box 1130 0 Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 Soda Disp Fax: (920) 236 -5084 OJHKOJH ON -I• {E: WJ ,TCR 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 n ** 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 103 W q th IA ve Value (Including labor and materials) -4 I 1 6D Date f/ /o7 Den+0.1 �c c t Owner Thom&s D��a+rtciaf%t(Ilptt-tContractor =�s p[Lxmhino =i'�c ❑Single Family ❑Duplex ❑Multi- Family ❑Rental ®Co� 1 ❑Industrial Number of Fixtures: Bathtub Sump Pump Plaster Sink Roof Drain Shower San. Sump/Pump Scullery Sink Soda Disp Whirlpool Water Softener Service Sink Coffee Mkr Lavatory Standpipe Rec Shamp Sink Site Drain Toilet Garage FD Surgeons Sink Waitrs Stn Kit Sink Local Waste Sterilizer Ice Chest Disposal Bar Sink RPZ Valve Comm Ice Maker Dishwasher Breakrm 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 Meter 0 Gas 0 Elect 0 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr Clothes Wshr Hand Sink 1Z Wash Fntn Wtr Usage Mtr Lndry Tray Lab Sink Catch Basin Misc Fixtures Electric Contractor (for projects not requiring an EIV Form) Use / Nature of Work—a" ZWL�-� Z Size Material Type # Conn. Type } Sanitary Sewer law" E 44*' '4 s ,� Storm Sewer FEB 9 2012 Water Service , _ i T � _a _ I INSPEC! 1 -10 ": ,L K k c `� i- ;. 'JC "� 06/09