HomeMy WebLinkAbout2012-Plumbing (replace fixtures) g) CITY OF OSHKOSH No 152019
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 Fixture 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 FIr/Wst 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 AULTI-FAMILY(1510 WITZEL AVE-APT#2)/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 NY-kJ 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(wort■
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.
08/28/2012 06:46 9202311289 J RASMUSSEN PAGE 01/01
1nTal`.ky��t ce,9 0-vi 9.&A1Jl
P 0 Box 1130
Oshkosh,WI 54903••1.130
Phone:(920)236••5050 0)
Fax:(920)236-5084 , �
Q�E r 'AT._�_1
Plumbing Permit Application ON 7Wf• vAT..I?
I hereby apply for n 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 fcc(s)can be brought to City Hall,Room 205 or mailed to Inspection Sci 'ices, po Box 1 1.25,Oshkosh WI
54903-1.128. Commencing work without permit(s)will result in fees be{ttg doubled or SI00-00 plus the normal permit:fcc,which
ever-is greater.
OR
If_o_y ar'e n..cPpplracl, w2artfcipsik128 (n th.�..ealTlft ,(' ArcoiI?. .l.41 3►Ld h al'[ef 9-1/afg.11,42?41;. chCekhsre
**.Advisory-For applicable projects,an Electrical Installation Verification.(EIV)ford/.,signed by the MectriicaJ
Contractor or Homeowner(fn r'installations allowed to be performed by die homeowner)must be sntburittred
witli this permit application, .Applications submitted without an ETV when smelt is required, Will not be
processed for Permit issuance and will be returned for completion.
Job /-rip . , Value 3 0 a, ° Date_.J- 6—a
.Rob Address, t -r p_ W t +3�_•— !r alue(t(IC.�Jiang loot and MntcriA�-9) — ,.—••••, n ` -�''
't p4 S h l.. .i S t� l' 1 tf r 1 r`,C.
DSiingle Family Opuolex (531%lt;llti-Family D'Rental (1Co.mmerclal ❑Industrial
Number of Fixtures:
Plaster Sink _ goof Drain __----
Rnthutb — Sump pump - --
S�adlcry Sink _ __ Sock nit9 -
ShoWCr ..�. _ Sao.Sump/Pump ��
Si Sink Coffee Mkr
Whirlpnol Water Softener Service
- - ____
$hemp Sink Site Drain
hove[:ory, —r. Stntutpipc Rec. _-__ - -
Sur�cros Sink Wnitrs Sin ._-.-
Tcc.Cher.
,Kit Sink -�.-- Local WaAtc „_-__ Stcrili r _.___ —_
[tar Sink RPT Valve _-- _ Comm Ice.Maker ..
I
Disposal - --
13r¢nkrm Sink
Bidet Int(hews Trap
_,—..
Dishwasher __ --_..... Urinal Psi.t3rcnac Trap .—.._.
Clascrnr Sink - -
I'lrror Drain t?ye Wlfach Stn —.Exam Sink Beer Tap __�
Bose Bibb —_ Deduct Meter
r Prep Sirtk - Dipper Well _-_.. .-
Wot.er:Bona -. WI,' is 'ee Mir _-_,,,
1.:OAS r.;Elect f1 PwrVnt. /Floor Sink —„u___ Drink Porn
Wash Finn —� Wtr Usage Mi,r �.�
Clothes Wshr _- Hand Sink .-___ —
l.nMy Tray Loh Sink - Catch Basin. mist Pltmercs
Flccf is Contractor(for projects not requiring an ETV Form) __ -- —...--Use/Nature of Work
... _:.._ -tt Conn-Typo
gixc r�txt,eriat Yp”
Sanitary Sewer
Storm Sewer
W Yter Service
ns!CS
Received Time Aug. 28. 2012 7: 34AM No. 0624