HomeMy WebLinkAbout0151467 - Plumbing (repair sanitary lateral) CITY OF OSHKOSH No 151467
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1821 JACKSON ST Owner 1821 JACKSON STREET LLC Create Date 08/01/2012
Contractor D.R. HANSEN PLBG. Category 444-Commercial-Exterior Laterals 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 _ 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 COMM/Repair sanitary sewer lateral at connection to main sanitary sewer under sidewalk
of Work
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 Repair
Storm Sewer
Water Service
Parcel Id#
1219290000
Valuation $1,000.00 Plan Approval ___ $0.00 Permit Fees $50.00 ❑ Permit Voided
Issued By Date 08/01/2012
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 55 KNAPP ST OSHKOSH WI 54902 -3448 Telephone Number 233-1595
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
1'O Box 1130
Oshkosh,WI 54903-1130
•
Phone:(920)23615050
Fax:(920)236-5084
• -'- ON THE WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the fofowing phimbing on the premises hereinafterdesaribed,the work to c onformto the .
Wiaoonsm State Plumbing Code,In the pe framonce of which all parties hereto agree to and are bound by said statutes.
• Application(s)and fee(s)can be brought to city gall,Roam 205 or nailed to don Services,PO Box 1128,Oshkosh WI
54903-1128. Commencing work W> .t peones)will resnlcm fees being doubled or 81001)0 plus the nomal pmt fee,which
ever is greater.
OR
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