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Home My WebLink About0151940 - Plumbing (associated w/cross connections report) CITY OF OSHKOSH OSHKOSH No 151940 SHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1331 ALGOMA BLVD Owner CITY OF OSHKOSH Create Date 08/24/2012 Ca Contractor GARTMAN MECHANICAL SERVICES Category 442-Commercial-Interior(New/Relocated Fixt Plan Inspector Jerry Fabisch - Bathtub ----- Clothes Wshr Classrm Sink Shower Surgeons Sink Roof Drain Lndry Tray Exam Sink Deduct Meters ---- Sterilizer Soda Disp ---- Whirlpool P Sump Pump F Prep Sink RPZ Valve P Wtr Sewer Mtrs Lavatory San Sump/Pump 1 Coffee Maker Misc. Usage Mtrs ------- P P FIr/Wst Sink Bidet ---- Toilet ----- Site Drain Water Softner Fiisu. Hand Sink ---- Urinal ---- Fixtures Wait.St. Kit Sink Standp Rec ----- _ Lab Sink Beer Tap Ice Chest Disposal Gar Drain Plaster Sink Dishwasher - -- _-_ Dip Well Comm Ice Maker Local Waste Sculry Sink Drink Ftn ---- Int Grease Trap Floor Drain Bar Sink Sery Sink Wash Ftn Hose Bibb ---- Ext Grease Trap Breakrm Sink Sham Sink P Catch Basin — Water Heater Eye Wash Statn Use/Nature COMM/plumbing associated with the cross connection control report of Work Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# Valuation $1,400.00 Plan Approval 1202630000 pproval $0.00 Permit Fees $0.00 ❑ Permit Voided Issued By __--_ Date 0.8/24/2012 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 520 W SOUTH PARK AVE OSHKOSH WI 54902 -6470 Telephone Number 920-231-5530 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), yp Number. Unless specified otherwise, we will assume the project is ready at the time the request is�received. Work may Phone continue if the inspection is not performed within two business days from the time the project is ready. Latch),Tray — _...---- ro6 4 p City of Oshkosh Inspection Services Division P 0 Box 1130 Oshkosh,WI 54903-1130 Phone: (920)236-5050 Fax: (920)236-5084 /H777A-1 ON THE WATEP Plumbing Permit Application I hereby apply for a perrnit 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 / o u are a CO7ItraC107- artici atin in the Perniit Fee Account System and have ade,uate unds check here i ,ou want this rocessed throu h °Ur account , **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 Value(Including labor and materials) Date,-IC,D-Z/ -f I \ , Owner 6r -4,shit Contractor ' c._ AN, • ;C: OSingle Family ODuplex EIMulti-Family Ejltental OCommercial ['Industrial Number of Fixtures: Bathtub Disposal Drink Ftn Catch Basin _ Whirlpool Dishwasher Wait St wash Fin _ Lavatory Sump Pump Ice Chest Urinal _ - Toilet Ejector/Grind Exam Sink Gar Drain Res.Sink Water Sofiner Scuby Sink -.. Soda Disp _ Bar Sink Local Waste Hand Sink Coffee Maker _ Water Heater Clothes Wshr F Prep Sink Comm.Ice Maker _ 17 Gas 0 Elect C3 PwrVnt Bidet Sery Sink Site Drain _ -- Shower ---- Beer Tap Int Grease Trap Roof Floor Drain Classrm Sink Ext Grease Trap Standp Rec _ -- Ltdry Tray _____ Surgeons Sink R.P.Z.Valve Eye Wash Stu _ .--- Lab Sink Break=Sink Shamp Sink Wtr Sewer Mtrs - -- Plaster Sink Dip Well Flr/Wst Sink _ Deduct Meters - --_ Sterilizer Hose Bibs Wtr Usage Mtrs _ -__ Misc. Fixtures • 'Electric Contractor(for projects not requiring an Ely Form) Use/Nature of Work p ,k . z .1 ' • ' --- Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service I I