HomeMy WebLinkAbout0151769 - Plumbing � CITY OF OSHKOSH No 151769
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER 5--�O-13 �
Job Address 413 W 14TH AVE Owner MARK S/NICKIE K TRITT Create Date 08/17/2012
Contractor DAVID BLYTHE Category 410-Residential-Interior Plan
Inspector Jerry Fabisch
Bathtub 2 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 0 Lndry Tray 0 Exam Sink 0 Sterilizer 0 Soda Disp 0 Wtr Sewer Mtrs 0
Whirlpool 0 Sump Pump _ 0 F Prep Sink 0 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory _ 2 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. p
Toilet 2 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. 0 Fixtures
Kit Sink 1 Standp Rec 0 Lab Sink 0 Beer Tap 0 Ice Chest 0
Disposai 0 Gar Drain 0 Plaster Sink 0 Dip Well 0 Comm Ice Maker 0
Dishwasher 1 Local Waste 0 Sculry Sink 0 Drink Ftn 0 Int Grease Trap 0
Floor Drain 0 Bar Sink 0 Serv Sink 0 Wash Ftn 0 Ext Grease Trap 0
Hose Bibb 0 Breakrm Sink
Water Heater 1
Use/Nature FR/Plumbing work in association with the whole house remodel and 2nd story addition.
of Work
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Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0907340000
Valuation $2,500.00 Plan Approval $0.00 Permit Fees $63.00 ❑ Permit Voided�
Issued By Date 08/17/2012
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
AgenUOwner
Address "eiephone Number
To schedule inspections please call the Inspection Request line at 236-5728 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.
0 CITY OF OSHKOSH No 151769
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 413 W 14TH AVE Owner MARK S/NICKIE K TRITT Create Date 08/17/2012
Contractor HOMEOWNER Category 410-Residential-Interior Plan
Inspector Jerry Fabisch
Bathtub 2 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 2 San Sump/Pump FIr/Wst Sink _ Bidet Site Drain Misc.
Toilet 2 Water Softner Hand Sink Urinal Wait.St. Fixtures
Kit Sink 1 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 GreaseTrap
Floor Drain Bar Sink Sery Sink Wash Ftn Ext Grease Trap
Hose Bibb Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn
Water Heater 1
Use/Nature 8FR/Plumbing work in association with the whole house remodel and 2nd story addition.
of Work
1
Size Material Type # Conn.Type
Storm Water
Parcel Id#
Valuation $2,500.00 Plan Approval $0.00 Permit Fees 0907340000
�Vw _ _ $63.00 ❑ Permit Voided
Issued By Date 08/17/2012
The undersigned,in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the
principle residence of the undersigned,hereby acknowledges,per Wisconsin State Statutes,ss 145.06,that other individuals
will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing
the work involved must be covered by a permit issued to a properly licensed Master Plumber.
In the performance of this work, I ag�re to pe orm all work pursuant to rules gove ging the described construction.
Signature aj��G�L.� /�i, ��-i/ lam, .,t/t) Date 1-7,--/"...2.
Agent/Owner
Address 413 W 14TH AVE OSHKOSH WI 54902 6539 Telephone Numbe� ;,,Z 3Q11
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.
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.
City of Oshkosh �.
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920)236-5050
Fax: (920)236-5084 O/I IKOJH
ON THE WATER I I
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 R
**Advisory-For applicable projects, an Electrical Installation Verification(ETV) 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 913 4)' Hi +L A-c/-e_ Value (Including labor and materials) N? SO 0 Date
Owner %�f eo4-lurk Tri Contractor
M Single Family ❑Duplex ❑Multi-Family ['Rental ❑Commercial ❑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 o2 Garage FD Surgeons Sink Waitrs Stn
Kit Sink I Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher I 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
tvGas 0 Elect XPwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink 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
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
06/09