HomeMy WebLinkAbout0151673 - Plumbing (replace dishwasher) CITY OF OSHKOSH No 151673
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2230 MEADOWBROOK CT#E Owner ROBERT A ROSE Create Date 08/13/2012
Contractor RAUSCH PLUMBING Category 443-Commercial-Interior(Replacement Fixtun 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 Scully 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 1CONDO UNIT/REPLACE DISHWASHER **check#27038
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0620490000
Valuation $113.00 >Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By 1.J ' W Date 08/13/2012
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.
Date
Signature
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 eicii—1)116'
PO Box 1130
Oshkosh,WI 54903-1130 oN ..
Phone:(920)236-5050
Fax:(920)236-5084
Plumbing Permit Application
I hereby apply for a permit do and install the following plumbing on the premises hereinafter described, he e work k to conform to the
Wisconsin State Plumbing Code,in the performance of which all parties hereto agree PO Box 1 128,
doubled or$100.00 plus the
can be brought to City Hall,Room 205 or mailed to Inspection Services,
• Application(s)WI and 3-112 work without permit(s)will result in fees being
Oshkosh WI 54903-1128. Commencing heck here
normal permit fee,which ever is greater. 't a` uv add ua1e urr
OR . c , lit'ci„tip • , , „ '
1 on are a contract, e - • i , r , , . , • . 2
i 'on Irani thi •,c�s ed !N _ Z
Date
A- .alue(Including labor and materials) - /
Job Address.- _ � Contractor �� � G-•
s► I ��' 1 []Commercial ['Industrial
Owner Renta
❑Single Family ❑
Duplex Multi-Family
Catch Basin
Number of Fixtures: Drink Fm Wash Ftn
Whirlpool Dishw s Wait.St.
Dishwasher Urinal ----
Whirlpool Ice Chest
Sump Pump Gar Drain
Lavatory Exam Sink
Ejector/Grind Soda rain
Reset Sculry Sink
Water Softner Coffee Maker Disp
Res.Sink Hand Sink
Local Waste Comm.Ice Maker
Bar Sink F Prep Sink
Clothes Wshr Site Drain
Water Heater Sery Sink
❑Gas❑Elect O PwrVnt Bidet Roof Drain
Int Grease Trap Standp Drain Shower Beer Tap Ext Grease Trap
Floor Drain Clessrm Sink Eye Wash Stn Rec
R.P.Z.Valve
Lndry Tray Surgeons Sink Wtr Sewer Mtrs
Shame Sink
Lab Sink Breakrm Sink Flr/Wst Sink Deduct Meters
Plaster Sink Dip Well Wtr Usage Mtrs
Sterilizer Hose Bibs
Misc.
Fixtures OR ❑Electric Installation Verification form attache
Electric Contractor (If Replacement) )
Use/Nature of Work � d
Size Material Type
# Conn.Type
Sanitary Sewer
Storm Sewer
Water Service 11i