HomeMy WebLinkAbout0151646 - Plumbing (replace dishwasher) CITY OF OSHKOSH No 151646
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 719 MOUNT VERNON ST Owner DOUGLAS/MARINAA BRATLEY Create Date 08/10/2012
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 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 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 SFR/REPLACE DISHWASHER **check#27031
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1000160000
Valuation $11 .00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By all Date 08/10/2012
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
Oshkosh,WI 54903-1130
Phone:(920)236-5050 °t
Fax:(920)236-5084
Plumbing Permit Application
I hereby apply for a permit m to in and install the following plumbing on the premises hereinafter
to and described,d,the w sat cotnteam to the
Wisconsin State Plumbing Code,in the performance of which all parties hereto agree Inspection Services,PO Box 1128,
can be brought to City Hall,Room 205 or mailed to Insp doubled or$100.00 plus the
• Oshkosh WI 49 fee(s) work without permit(s)will result in fees being
Oshkosh WI 54903-1128. Commencing
normal permit fee,which ever is greater.
t . ei al , , •ve add,uate nd check here,i
1 ou are a co rtract r r a 'crl"t`' �� ` � a � I ,
i eau want this r' 's ed t
Date
324/)._
f / t , A kf'<' 10 Value(Including labor and materials)' a _c p/,,,, .
f' 1-C Contractor Industrial
Owner Rental :Commercial ❑
Single Family ❑Duplex []Multi-Family ❑
Number of Fixtures: Catch Basin
Drink Ftn
Bathtub Disposal St. Wash Ftn
Whirlpool Dishwasher —Z--- Wait.Chest C Urinal
Lavatory Sump Pump Ice Ice C Sink Gar Drain
Toilet Ejector/Grind Scully Sink Soda Disp
Res.Sink Water Saner Coffee Maker
Local Waste Hand Sink
Bar Sink F Prep Sink Comm.Ice Maker
Bidet
Water Heater Clothes Wshr Site Drain
Sery Sink
0 Gas O Elect O PwrVnt Roof Drain
Shower Beer Tap lnt Grease Trap
Floor Drain Classrm Sink Ext Grease Trap
Standp Rec
R.P.Z.Valve Eye Wash Stn
Lndry Tray Surgeons Sink Wtr Sewer Mtrs
Lab Sink Breakrm Sink Shamp Sink
Flr/Wst Sink Deduct Meters
Plaster Sink Dip Well Wtr Usage Mtrs
Sterilizer Hose Bibs
Misc.
Fixtures
Electric Contractor OR ['Electric Installation Verification form attached
(If Replacement)
Use/Nature of Work • ! 6; - �I dr
Size Material Type
# Conn.Type
Sanitary Sewer
Storm Sewer
Water Service 1 L/C