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Home My WebLink About0152179 - Plumbing (remodel bathroom0 CITY OF OSHKOSH No 152179 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 609 E IRVING AVE Owner JEFF M/THERESA M SALZMAN Create Date 08/13/2012 Contractor MT. MORRIS PLUMBING Category 413-Res-Interior(Replacement Fixtures) __ Plan -- --- Inspector Jerry Fabisch _ --- Deduct Meters Bathtub _ 1 Clothes Wshr Classrm Sink Surgeons Sink Roof Drain — - Wed Deduct Me errs Lndry Tray Exam Sink Sterilizer Soda Disp Shower r'Y Y --- -- Whirlpool Sump Pump ---- F Pre Sink RPZ Valve Coffee Maker _Wtr Usage Mtrs p — Misc. Lavatory San Sump/Pump FIr/Wst Sink — Bidet Site Drain _ ry Fixtures Toilet Water Softner Hand Sink Urinal Wait.St. Kit Sink Standp Rec Lab Sink Beer Tap Ice Chest — — Well Comm Ice Maker ___ Plaster Sink Dip Disposal Gar Drain Scul Sink Drink Ftn Int Grease Trap Dishwasher Local Waste rY 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/Remodeling the existing bathroom to include the installation of a new tub and wall surround. No other areas of of Work the bathroom are being remodeled. Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# 0405990000 Valuation $400.00 Plan Approval $0.0_0 Permit Fees -_ $25.00 ❑ Permit Voided Issued By 2--:_e Date 09/07/2012 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 W6115 COUNTY RD W WAUTOMA — WI 54982 -7842 Telephone Number 1-920-765-0665 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 of Oshkosh Inspection Services Division P 1130 Oshkosh,WI 54903-1130 �(��/(1111 111111111-) Fax:(920)236-5084 EIII t IOIH Fax:(920)236-5084 � 1 ON THE WATER •Plumbing Permit Application I hereby apply for a 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 fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI 54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which ever is greater. OR If you are a cantr_ac or Darticipatin2 in the Permit Fee Account System and have adequate funds, check here if you want this processed through your account n **Advisory-For applicable projects, an Electrical Installation Verification(ETV)form,signed by the Electrical Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted with the permit application. Applications submitted without an EIV when such is required,will not be processed for Permit Issuance and will returned for completion. Ave_/ ) Value(Including labor and materials) Li Ob'� Date Job Address ( c l F 1 f V��1 t / /, ' R b - C .-kl VvistaiSiji /HrH,M3 Owner ` �lfl'�'.�� 3 �� a�LmQ,n Contractor < o KSingle Family [Duplex [ Multi-Family []Rental OCommercial ElIndustrial 10(,,.,.,r Number of Fixtures: Bathtub 1 Sump Pump Plaster Sink Roof Drain Shower San.SumpJPump Scullery Sink Soda Disp Whirlpool Water Softener Service Sink Coffee Mkr Lavatory Standpipe Rec Shamp Sink Site Drain Toilet Garage FD Surgeons Sink Waitrs Stn Kit Sink Local Waste Sterilizer Ice Chest Disposal Bar Sink RPZ Valve Comm Ice Maker Dishwasher Breakrm Sink Bidet Int Grease Trap Floor Drain Classrm Sink Urinal Ext Grease Trap Hose Bibb Exam Sink Beer Tap Eye Wash Stn Water Heater F Prep Sink Dipper Well Deduct Meter Cl Gas Q Elect D PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr Lndry Tray Lab Sink Catch Basin Misc Fixtures Electric Contractor(for projects not requiring an EIV Form) Use/Nature of Work rep/go__ l L/ 04d UQ /& Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service 06/09