HomeMy WebLinkAbout0151767 - Plumbing (remodel Kitchen and bath0 CITY OF OSHKOSH No 151767
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1130 N WESTFIELD ST Owner EVERGREEN MANOR INC Create Date 08/17/2012
Contractor J RASMUSSEN PLUMBING INC Category 443-Commercial-Interior(Replacement Fixtur' Plan
Inspector Jerry Fabisch _
Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters
Shower 1 Lndry Tray Exam Sink Sterilizer Soda Disp Wtr Sewer Mtrs
Whirlpool Sump Pump F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory 1 San Sump/Pump Flr/Wst Sink Bidet Site Drain Misc.
Toilet 1 Water Softner Hand Sink Urinal Wait.St. Fixtures
Kit Sink 1 Standp Rec Lab Sink Beer Tap Ice Chest
Disposal 1 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 ICOMM(MS1033)/REMODEL KITCHEN AND BATH **debit acct
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1608640000
Valuation $4,000.00 Plan Approval $0.00 Permit Fees $42.00 ❑ Permit Voided
Issued By O , t ) Date 08/17/2012
In the performance of this work,I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1914 GREENBRIAR TRL OSHKOSH WI 54904 -8887 Telephone Number (920)233-6747(work
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
08/16/2012 18:50
U 0 9202311289 J RASMUSSEN PAGE 01/01
I11Rne: (92,S'C136.5 i DIi'iJtjld
P0Rox1130
Oshkosh, Wi.54903_1.130
Phone:(920)23+5-•SOSO O
FRY:(920)23f-5084
k -
d Plumbing Permit Application OBI !-!F M1A7ER
i hereby apply for a.permit to do and install the following itllunbing pp the 1.
Wi9conSin State Plumbing Code,in the P elnisea hereinafter described.the work to conform to the
FurCofttzatlCe of t>uhich all parties4 hereto agree to and are bound by said statutes.
a Application(s)and'fee(,a)oan be brought,to City Hall,Room 205 or mailed to inspection Cervices,PO i3ox 11,2$,Oshkosh Wi
54903-1128. Commencing work without permit:0 will result in fees being dcmbled or$100.00 plus the normal permit tee, which
ever ir;greater.
OR
g _2 rbe Pe>�Rr'f cc 2lUl 51!lemaaar . r�eaP��!. YsGAeck fjErg_.__
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44 Advisory-For applicable projects, an Electrtical Installation Vexiicatairna(ETV)form .,signed hp the Electrical
Contractor or Homeowner(for installations allowed to he performed.by the homeowner)must.he submitted
with the permit application. .Applieatio nc submitted without an ETV when such is regimed.,wall not he
processed for Permit Issuance and will be returned for completion.
TO ]o� j-)/4,--(L.
J b Addre s_I/3 0 N. L) Value(Mauling lnhnr and mnmrinls) ae __
Owner —__ _ Contractor � ohs ►w u 1. a a0 P 1 p , .r-'C ,
[Single Family []huller fMn)ti-Fsmily L Rental SiConimereial DIndutatrlal
Number of Fixtures:
%thud, __ ,____ Sump Pnrnp Plaster Sink RenrDrain
Chewer _-.l San.Sump/Pump ---._ Scullery Sink _____ Sndn Diap __--_
Whirlpool ,,,,,,,_ Water Softener __,_. Service Sink CoffeeMkr _ ___
Lavatory
1 ^._ Standpipe Rae _ .; 9hamp slink Site Drain
Toilet i Game Fla --
Kn Sink I 1�'astr.. _—_—_„ Starili2ir r —_
Disposal ..._i_ Bar Sink RPZ Valve
--- Comm tee Maker
1){sit„rrcher _r_—. un:nkma Sink ., —,-, Bidet IntCirnnseTrap ----
cloot Drain Clagsrm Sink --_ Urinal �T._ Exl Grease True _—__
Hose Bibb ._,__--• I:?xnm Sink _--_—, Beer Tap _._ . Eye Wash Sin _.
Wirier Rentcc F 1'rCp Sink __- Dirac Well ------, Outlet Mrrcr
_:OAS i;?Meet 11 PwrVnt Floor Sink •__,— Drink Prtfi _
..�....,.._ Wtr Sower Mtr __--
Cfothes Wshr ________ Hand Sink r-- Wash Patti ^-- Wit Usage Mir —
f.,ndry Tray ...--_—_ Leh Sink ,___-_ Catch Basin —`_ Miv:Pismires „y.,,_•,_
Electric C'oeltractor(for projects not requiring an ,EIV Form) _......_....._._____„-
Use/ Nature of Work___,R 4.m-b.
.a rCno O.. it._A'1 S lei 33 fG.i—.94-•,..- r rr
Size Material Type # Conn. Type
Sanitary Sewer
Steen Sewer
Water Service
o/o?
Received Time Aug. 16. 2012 7: 38PM No. 0473