HomeMy WebLinkAbout0152141-Plumbing (remodel) CITY OF OSHKOSH No 152141
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3675 N MAIN ST Owner TREMBLY ENTERPRISES LLC Create Date 09/05/2012
Contractor D.R. HANSEN PLBG. Category 442-Commercial-Interior(New/Relocated Fixtt 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. 1
Toilet 3 Water Softner Hand Sink Urinal 1 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 Sculry Sink Drink Ftn 1 Int Grease Trap
Floor Drain Bar Sink Sery Sink _ 1 Wash Ftn Ext Grease Trap
Hose Bibb Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn 1
Water Heater hand wash
Use/Nature COMM/plumbing associated with remodeling project
of Work
I
J
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1519605400
Valuation $9,000.00 Plan Approval _ _ $0.00 Permit Fees $56.00 ❑ Permit Voided
Issued By 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.
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.
City o 'Oshkosh • °
Inspection Services Division
P O Box 1130
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax (920)236-5084
o,rid wwrER
Plumbing Permit Application
I hereby apply for a prank to do and install the fnl owi gg plm nbmg on the premises hereinafter descrybed,the wodc to conform to the
Wisconsin State Plumbing Code,in the performance ofwhich all parties hereto agree to and are bound by said statutes.
• Application(s)and ihe(s)can be brought-to City Nall,Roam 205 or matted to Inspection Services,PO Box 1128,OsbkOsh WI
54903-1128. Commencing ng work without permit(s)will resat in fees being doubled or$100.00 plus the normal permit tee,which
ever is greater.
OR
. ,_ e . . :,..t ' t, ,, yi -f.atf<.: ,, re• •er 1 'eel. • ... .y ! a - dh•1 , tat L a ::, , . re :
If you want this processed throuflt your account n
'Advisory-For applicable projects,an Eleatiad Installation Veri nn(EIV)form,signed by the Electrical
Contractor o Rum owedtabe.p psfedbytlte]ettmea TImustbesubmitted -- ,
. with the pandt application. Applications Submitted-withodifitaNkilligaiii eginoiieil;WM not be '
processed for Permit Issuance and will be wed for completion.
Job Address 30. n tn 5i Value te n and. ls)4 (1600.°d Date 9,'51 I'D
Owner "Train b1.; eriffpitse5 contlistctor D . 4 ` Iuvkbi il 4
❑Single Family ❑Ahplex [Mniti-Fan* ❑Rtetstat- 1'WZmercial 6 r i i ustrial
Number of Natures:
Betmb Satbp Pomp Pinter Side RadDeakt
Shower San. SodaDitp
Wtdcipoo; Wafer&Meow Service Sink __I_— hikr
Laos► Slmalpipc it Shan"SING Site Drain
Toilet J Garage FD • &nem Sink Waite sm
KiitMtk Local Waste Shaker imams
Disposal Bar Sink RPZ Valve Cows Ice Maier
Dtsbwashe r - Since Bidet Tat(array trap
Floor Drain 0035Z02 Si* Urinal _.1_,___ Ent tease Top
Moo Bibb Beats Wank Beer T, Bye Wash Sh. _-,__
WaterHenter P Pimp Sink - Dipper Well DedactMeter
0 Gas 0Elect°ParVm Floor Shale D 1..._ •WtrSewrrher
clothesWSbr Hand Sink . uhf , . WlrtbageMtr
Wry Tray tab Sink - Catch Basin best Mtn=
Marta 1, h
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work .
Size Material Type # _ _ Cates Type -
Sanry Sewer •
Stern Sewer
Water Service
•
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' 06/09
Received Time Sep. 5, 2012 9: 48AM No. 0723