HomeMy WebLinkAbout0151411 - Plumbing ( replace toilet) CITY OF OSHKOSH No 151411
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1736 BERNHEIM ST Owner JOHN C/TERRI R MARXEN Create Date 07/30/2012
Contractor RAUSCH PLUMBING Category 413-Res-Interior(Replacement Fixtures) Plan
Inspector Jerry Fabisch
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 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/REPLACE TOILET **check#26995
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1331920000
Valuation 's$78.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By( �� ;, )1() Date 07/30/2012
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 1606 W HASKEL ST, STE A APPLETON WI 54914 -5032 Telephone Number 920-830-9222
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
PO Box 1130 0
Oshkosh,WI 54903-1130 aN
Phone:(920)236-5050
Pax:(920)236-5084
Plumbing
Permit Application
bin on the premises hereinafter described,b�d by said conform the
I hereby apply for Sa tate permit m to in and de,in the following plumbing g hereinafter
to an
Wisconsin State Plumbing Code,in the performance of which all parties hereto agree PO Box 1128,
doubled or$100.00 plus the
s can be brought to City Hall,Room 205 r m ciledlt to in fees being Services,• Application(s)WI and fee(s) work without permit(s)
Oshkosh WI 54903-1128. Commencing nds c eck here
normal permit fee,which ever is greater. [ u a f 1 ,y• ado•uate
OR �� • ,
au are a c� ttrac[.r • • 'c1• •[i •< I . � ,
I r , . �
i ,ou want th's r•o es e• I • . '
�'� Date
/_ / i , alue(Including labor and materials) 40i
Job Address (� Contractor 4.4. ` 4.I ---6/, Commercial ❑industrial
Owner 0 Rental ❑
Single Family ❑
Duplex []Multi-Family ❑
Catch Basin
Number of Fixtures: Drink Ftn Wash Ftn
Disposal watt.St. ----
Bathtub Urinal
Dishwasher Ice Chest
Whirlpool Gar Drain
Sump Pump
Toilet Exam Sink Gar rain Disp
_— Ejector/Grind Sculry Sink
Reset Coffee Maker
Water SoBner Hand Sink ---
Res.Sink Comm.Ice Maker --
Local Waste F Prep Sink
Bar Sink Site Drain --
Bidet Wshr Sete Sink
Water Heater Roof Drain ---
❑Gas 0 Elect O PwrVnt Bidet
lnt Grease Trap Standp Drain Shower Beer Tap
Ext Grease Trap Eye Wash Stn —
Floor Drain Surgem Sink R.P.Z.Valve
Lndry Tray Surgeons Sink Wtr Sewer Mtrs --
5hamp Sink
Lab Sink Breakrm Sink Deduct Meters
Flr/Wst Sink
Plaster Sink Dip Well Ded Usage ors
Sterilizer Hose Bibs Mtrs —
Misc. attSCll
Fixtures Q [Electric Installation Verification form
Electric Contractor (If Replacement)
Use 1 Nature of Work
Size Material
Type # Conn.Type
Sanitary Sewer
Storm Sewer
1
Water Service