HomeMy WebLinkAbout2012- Plumbing (replace fixtures) CITY OF OSHKOSH No 152021
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1510-1520 WITZEL AVE Owner NORMANDY VILLAGE LLC Create Date 08/29/2012
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 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 FIrNVst Sink Bidet Site Drain Misc.
Toilet 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 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 MULTI-FAMILY(1510 WITZEL AVE-APT#3)/REPLACE FIXTURES '"debit acct
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0611440000
Valuation $300.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By afn(/ .) Date 08/29/2012
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.
V 08/28/2012 06:44 9202311289
3 RASMUSSEN PAGE 01/01
Inspection Service f)Ivis91on
P 0 Flox 1130
0Shkoah,W154903-1130
Phone:020)236-5050
Pax:(920)236-5084
•
Plumbing Permit � y„ =
Application ON iHl h�ATr:,r
I hereby apply fur n.permit to do and install the following i?lu.tllt,in,�On the prelni�acs het•eil]atl��r tJc:SCrihecl,thc t�rrn•k.�,conform 10 the
�1liaconsin State Plumbing('ode in the perfalrrntaararc of which a.I1 parties hereto agree to and are bound by said stsatutes.
a Appriaatinn(s)and feels)can be brought re City.Hall,.Room 205 or mailed to InSpect:ion Services,PO 1)ox 1125,Oshkosh Wit
549034128. Ccl.mincnring WOrk Without perenit(s)will Malt in:Fees being douNed or$100.00 plans the normal permit fee,which
tear is greater.
OR
1.y a w_e_c £,t_2r par ricivating In 4 th ZE it E, 6
--LSJIT�4nt $Yitefil.,.F ,4,..agve odes tt&fu�?ds_check here
112u H_ ? .> .5...,p_ILC_.S.tAd eMz orrr grce nl _"
**Advisory-For applicable project's, an Electrical Installation Verification(ETV)fonii, signed by the Electrical
Contractor or Homeowner(for installations allowed to he perfforrmed by the hollraeowner)mast be slnbJt d ted.
with the permit application. Applications submitted.without an ETV when such is required.,will not be
processed for Permit Issuance and will be returned,for completion.
Job Address__ /Se/ b L f,t 3 Jai V (Including 3 __` M 6__/7.
.,, R11U�C Inclndln labor materialsl, .- �Rt�
Owner — LD w e�,o,..` kf Contra.ctolr t P.AS ►+^•U 1 S .e is-)
p ._f-'r.
nkliilmgle Family nJ)mpilei OMtniti-Fimfly ❑Resntal (]Commercial Dbidustrtal
Number of fixtures:
R;tJmrb •,.. ___- Sump Fue+p ,__ Mosier Sink Roof Drain --_
Shower Sim,Sump/Pimp -- Scullery Sink ,.•--- 4rrda Dims __.,_...
Whirlpool ...., _ Writer Softener - Service Sink ,_____ Cnfine Mkr ,
Lavatory _._..___.. Standpipe Rix --_,_,:, Shamp Sink __ .__,. Site brain ..,.._--
T'nilrS _ . Garaec Ill) __,— Surgeons Sink _,— Waitri Stn __
Kit Sink ` .__ Local WaRl:c —_—„-, Sterili7A:r _ Ice Chest ___.,_.,,,
r7earnaal _ ,. Bar 4in�r. _—___ RFZ Valve _-__ Comm ice Maker _
ni4h hc- �_ Brcnkrrn Sink —T Bidet -,..� 1nt(beast Trap -- -
Cltsstm Sink _„ __•_, Urinal -„-_^ Ext Grctac Tian Drain ^_,
]'lose Flil h
Exam Sink --___ Boa Tap _� F.ycwash Sin ,,,
water]Sauer ____ F Prep Sink .-•—_ Dipper Well -- Deduct Mctcr -----_
l(ins I:i 1;wt rl Pwrum nom sink _, Drink T'irm .._.-..._ We.Sewer MP- --_
Clothes Wshr _--__,,,, Hand Sink _ Weall Finn Wit Usage Mir ---
l..ndtv Trny 1.0)Slnk -,,.,,,,.,, Cneth Fain
Electric Contractor (for projects not requiring an ETV Form)
ii-
Use/Nature of Work, _K:z fl L.< -fi 11.-u%rz
------------.----Kiie-c - -- - Material, I J f►c- Conn.Type
-----__•-
Sanitary Sewer .
Storm Sewer
Water Service
AA/o9
Received Time Aug. 28. 2012 7: 32AM No. 0622