HomeMy WebLinkAbout0152126-Plumbing (misc. interior) CITY OF OSHKOSH No 152126
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1952 HUBBARD ST _ Owner STEVEN L/GUDRUN HEMMINGHAUS Create Date 09/05/2012
Contractor J RASMUSSEN PLUMBING INC Category 410-Residential-Interior Plan
Inspector Jerry Fabisch
Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters
Shower Lndry Tray 1 Exam Sink Sterilizer Soda Disp Wtr Sewer Mtrs
Whirlpool Sump Pump 1 F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory San Sump/Pump FIrIWst Sink Bidet Site Drain Misc.
Toilet 1 Water Softner Hand Sink Urinal Wait.St.
Fixtures
Kit Sink Standp Rec Lab Sink Beer Tap Ice Chest
Disposal Gar Drain Plaster Sink Dip Well Comm Ice Maker
Dishwasher Local Waste Scully 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 SFR/INSTALL LAUNDRY TUB,SUMP PUMP AND REPLACE TOILET **debit acct
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1409200000
Valuation $2,000.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By , ---0 Date 09/05/2012
In the performance of this work,I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Date
Signature
Agent/Owner
Address 1914 GREENBRIAR TRL OSHKOSH WI 54904 -8887 Telephone Number (920)233-6747(work
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
09/05/2012 06:47 9202311289 J RASMUSSEN PAGE 01/01
tnopection Services Division
�'4?Box 1130
Oshkosh,liVl S4�9Q3-1130
#14
Phone;(920)236-:5050
Fax:(920)236-5084
lPlumbira }�fU��-
g Permit Application cu rr�r N%nsrc
I hereby apply fora permit to do and install the.fallowing pinmhing on the premises hereinafter deseilbetl,the work to conform to the
`IJiyeonsin State Plumbing Code, in the performance of which all parties hereto agree to and$tre bound by s'aid stntt,,ics.
• Application(s)Sand fee(s)can he brought.to City Hall,Ronnt 205 or mailed to inspection Seiy'iccg,PO i ox 1128,Oshkosh WI
54903-112$. ('ornmcncing work without perrnit(s)milli result in fees being doubled or$100.00 plus the normal permit:fee,which
ever is greater.
OR
Lf.,_YS 21._g_ g__c9nrt ac,POr arliclnigrit:tz•tit else Permit I'-_ AQQtttLnystm or..d have adegtrandlinds,_ chec/i berg
I'._Y.nv ►.Carat,.zhi,li.,nr.ecAt,tg.CiatIft/igiL_Y_M_accntry far
**.11,rlpisoiry-Ent applicable projects, an Electrical Installation Verificati.om(ETV)form,sigo..ed by the Electrical
Contractor or Homeowner(for installations allowed to be performed.by the homeowner)ma ast be siabroiittcd.
with the permit supplication. Applications sod nitted.without an JElV when such is required,will not be
processed for Permit Issuance tend.will be returned fray complettion.
Ct—Job A ddriec4_/ J �`� 7 ti Ci �V$I>fac(lnchtAing lsh a and materials) 42 OD C?-�'� 1)Mt__. �-(__
owner He�'^ •� kts .. Lt Contractor •3-1 _- 1�-C S u _. .e t�' �) i e r I:is)C
,Sitrwglc Fa,noIly []A>niplex ❑Malts-Fawity (]Rental L]Coin{alltcr�eclal (]industrial
Number of Fixtures:
Rnthizrh _-__ _. Sump romp 1 Planter Sink __M. RonfDra.in ._,. ------
Shower „_—...,.. Ss%sump,rrump --..... "uai{1cry Sink ------ sadaDiap -----
Whirlpool ____ WMn Softener .„ Scrvico Sink ______ Coffee.Mkr ...—,_.,
IAwn:ay standpipe Rcc , .___. Shamp Sink --.-_-„_ Sim.Drain _-..,. ..._
Toilet —1... OA rage F1) _�_�. Surgeons Sink Waitrs Stn ---.
.Kit Sink ___-.. Loa Waxtc —_ Srarilizcr -_—.,. 1cc Chcai. _ .
ni.ahosal _— 13nr Sink . ... -- RPT...Valve ..- ----_ Comm Ice.Maker --.-
-
Dishwasher timnttrm Sink Akict. _-.... ., tnt Grosso,Trap _._..-.--.
Flom flrnin _-_ — Classrm Sink •--.., Urinal _..,_.,__ �.Opener,.Trap
Exam I1nac fiikrh x mt Sink ---_— Agar Tap —, Eye Wash n
91
Water Mincer F Prop Sink __..„-... tipper wet! _,....—_ ikduct Miter _—_.-
0 nns(i t?lect IT;nnaVni Floor Sink ___ Drink stir _____ 1utr Sc+lrlrTtAtr ----.u-_
c.'lothen WsIir .__ Hand Sink - „-___ Wash Fmn _...-_.–- Wit-Usage Mu •_,.---
1.ndry Tray I_„ I.,nh Sink ,._—.__ Catch Aaain —_ Misc 1'i,inims __.—._
Electric Contiractor(for projects not requiring an ETV Form) ^__—... ___ -_--
tid, 11 `tk A P.. -y 1 I) a.•%1 A: ('`Ai . _J`{ 0 14 �! (_-4
Use/Nature of 41Vi�r�. - CI _ ,,._ .-- ----.
Size Matti-in! Type It Conn.Type
Sanitniy Sorer
Storm Sewer
Water Servicr.
a 6!a9
Received Time Sep. 5. 2012 7: 36AM No. 0713