HomeMy WebLinkAbout2012-Plumbing (cross connection) (a) CITY OF OSHKOSH
No 152042
OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 110 PEARL AVE
Contractor D.R. HANSEN PLBG. Owner CITY OF OSHKOSH
Create Date 08/30/2012
_ Category 442-Commercial-Interior(New/Relocated Fixti Plan
Inspector Rich Wood
Bathtub Clothes Wshr Classrm Sink
Shower Surgeons Sink Roof Drain
Lndry Tray Exam Sink Deduct Meters
Whirlpool Sterilizer Soda Disp Wtr Sewer Mtrs
Sump Pump F Prep Sink RPZ Valve
Lavatory San Sump/Pump FIrIWst Sink Coffee Maker Misc.
Usage Mtrs
Toilet Bidet M
Site Drain Misc.
Water Softner Hand Sink
Kit Sink Urinal Wait.St. Fixtures
Urinal Rec Lab Sink
Dis osal Beer Tap Ice Chest
p Gar Drain Plaster Sink
Dishwasher DIP Well Comm Ice Maker
Local Waste Sculry Sink Drink Ftn
Floor Drain Bar Sink -- Int Grease Trap
Sery Sink Wash Ftn Ext Grease Trap
Hose Bibb Breakrm Sink Sham Sink
p Catch Basin Eye Wash Statn
Water Heater
Use/Nature Cross connection correction on orders by Hydro Design. City owned building waived fees.
of Work
Size Material
Sanitary Sewer Type # Conn.Type
Storm Sewer
Water Service
Parcel Id#
Valuation $100.00 Plan Approval $0.00 0100830000
Permit Fees $0.00 ❑ Permit Voided
Issued By
Date 08/30/2012
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 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.