HomeMy WebLinkAbout0151815 - Plumbing (inside water leak) CITY OF OSHKOSH No 151815
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER Create Date 08/20/2012
Owner STEVEN A/MARY B STRUENSEE /2 Job Address 1355 MARICOPA DR - -- ----"- --
- ---- ----
Category 401 -Residential-Exterior(laterals) _-------"
Contractor D.R. HANSEN PLBG. - - ----
Inspector Rich Wood
.------- ------- - -- Deduct Meters
Clothes Wshr Classrm Sink Surgeons Sink Roof Drain
Bathtub - -- Wtr Sewer Mtrs
Shower Lndry Tray
Exam Sink Sterilizer Soda Disp
F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Whirlpool _Sump Pump - Site Drain Misc.
Lavatory San Sump/Pump Flr/Wst Sink _ Bidet - Fixtures
-_
Toilet Water Softner Hand Sink Urinal Wait.St._ ----Kit Sink Standp Rec Lab Sink — Beer Tap Ice Chest
Gar Drain Plaster Sink Dip Well Comm Ice Maker
Disposal --- _ -
Dishwasher Local Waste Int Grease Trap
Scul Drink Ftn
ry Sink ---
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 Inside water service leak as notified by Water Department; Repair or Relay water service.***Debit Account***
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service 1" Copper Lateral 1 Repair
Parcel Id#
1312510000
$0.00 Permit Fees $50.00 r] Permit Voided il
Valuation $2,500.00 Plan Approval - — ------- Date 08/20/2012
Issued By �
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 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 Oshkosh
Serviices Aivisi on
(; ""111-1 ;)
P O Box 1130
Osblmsh,WI 54903-1130
Phone-.(920)73615050 LU
Fax:(920)236-5084 d
_ oN THE WAFER
Plumbing Permit Application
I hereby apply Boa-a permit to do and instal the following pla�mgl on the premises hereinafter desenbed,the work to conform to the .
Wisconsin Sly Phmdring Code,lithe performance of'which all panties hereto agree to and are bound by said sly.
• Application(s)and fee(s)canoe brought to City Han,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI
54903-1128. Commencing work w hoatpermit(s)will result in Bees being doubled or$100.00 plus the nominal pest fee,which
ever is greater.
OR
ee .. #_n_ .) -- 1, ,,_• , _ , . : _ # - # - ,e.
i . _ , • #t ed o ' # o, -' ,sort •
**Advisory-For applicable prgjeds,an.Electrical Installation yetifitsition(EIV)form,signed by the Electrical
Contractor our Brmiernvnertforinttallations.alknvettobe pe dby tbe!rnne0w.nerl t be mbn ed • '....-
. with the pet»t application. Applications anbniktted-withoittatinoltittiliiiresaiiid,ital natbe
processed for Pew Issuance and Will be returned for ebmpletIon
Job Address 1355 Sri cap l). value(Lseaas loglaboraodtst Fait°•eic' Date S1 X I P
Owner fftrryl 51vtirripz,. Contactor 0-3a i el
atingle Family �ples QNI�-Fam ily Jett
DCmmiaeacisl dastrial
Number of Farm es:
Baleab Smap l rep Plaster Sink RoofDotin
•
Shower Ssn NoWirtnen Sc ll ysink SociaDp
Whu9pooI Water tallow Sevice Sink Cabe her
'Lavatory standpipe Rec Skimp Sink SRO:halo
Toilet enrage D Surgeons Sink Wain:S
KitSink Loealwarste Sterilizer 10C Chest
Disposal Bar Siksk RPZ Valve Cowin Inc box
pivtsaravlerr _
Bred=Teak Billet Int QC=Top
Floor Drain Q®n Sink ,Mind Bet Grease Trap
Hose Bibb Baum sink BacsTap . Bps Wash Ste
Water Hauser F Prep Sink Dipper well Dedertlrterr
•
0 Gaga Met 0Pwrvet Plow Skit . urrmkPktn _ WlrseaerMh
Clothes Waft Mod Sink ' WashFe� _ WtrUange Mir
1�9'Da9 Lab Sink .Qtchaasin •' - A eFratmes
Electric Contractor(for projects not requiring an ELY Form)
Use/Nature of Work 1 .t. 'r ,t . - ..1i GE
• Size Mete lief Type 41 _. Conn.Type
Sanitary Sewer
Stoan Sewer
1 ``
Water Service '
' 06/09
Received Time Aug. 20. 2012 9: 08AM No. 0508