HomeMy WebLinkAbout0152198 - Plumbing (install storm sewerer lateral) CITY OF OSHKOSH No 152198
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1555 S OAKWOOD RD Owner BRENT GALLMANN Create Date 09/06/2012
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Contractor NOVAK EXCAVATING INC Category 401 -Residential-Exterior(laterals) 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 FINWst Sink Bidet Site Drain Misc.
Toilet Water Softner Hand Sink Urinal Fixtures
-- Wait.St.
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 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/installing a storm sewer lateral per code — — —
of Work
I
r
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer 4" Plastic Lateral 1 New
Water Service
Parcel Id#
Valuation $500.00 Plan Approval $0.00 Permit Fees $50.00 ❑ Permit Voided]
Issued By 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.
Signature
Date
Agent/Owner
Address PO BOX 389 RIPON WI 54971 -0389 Telephone Number 920-748-2512_
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.
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City ofOshkosh
Inspection Services Division
P h Boh 1130
Oshkosh,WI 54903 1130
Phone:(920)236-5050 _
Faux:(920)236.5084 r� H
CM PIE'WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following phnrbing on the premises hereinafter described, the work to conform to the
Wisconsin State l iumbing.Code,in the performaride 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 pernrit(s)will result in fees being doubled or S100.OJ plus the IlaTilliii permit fee,which
ever is great e,.
OR
if,,,,., are _, gntractor articlaaiin. in the Permit Fee Account System and have adequate fro(1..r. check hero.
Iyou wait t'i l_2rot.EsSie throUti.Lgur QCC014111 11.
*4 Advisory -For applicable projects, an Electrical Installation Verification(EIS)fort,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 EIIV when such is required, will not be
processed for Permit Issuance and will be r rued for completion.
Job Address /651)J l��?"1<L�L3f+(" Value (includin labor and atcnals , 2'.;a, q (�j` 2-
/� d ) r --- Date l ----
Owner L ,®t et. Contractor t�✓t , �� • - 'h , ,
,Singlo Family L;Dttplex L Niuiti-Family jltental � Cotnmerci t ' t`: Mr., i `l .
Number of Fat SEP 0 7 2012
liathtuh _._ Sump PunyP L`_.__ Flamer Sink Pod Chain D iu`'i .1‘11.-_1 ,T OF
Shower --_ San.Snrnp,!.anp —___ Scullery Sink ___ soda L�Sip9,111v1UNf-Y DEVEt-OPv':.ENT
whirlpool WscrSoftener _-__ Service Sink —.__�__ colt "'hi rCTIO i SEM.%'rC?=S VISIO
Luvator; _..-_—_ S mndpipc kec _____ Sherry �, Site Drain _. ,_-
Ctyilet --._-_._. Garage FD -- Surgeons Sink —.�_. WaitrS Sot _-
Kit
Sink ___._ Local —____-. Sterilizer ____� lee Chest —
Dis{rasal -- Bar Sri* RI3Z Valve ---,, Ceram ice Maker
Dishwasher Breakm Sick __— Bidet --- 'n'Urease'lrep _—_—
Floor Drain Clmon Sink _ Urinal Exc Grease Trap --_----
Bose Bibb _+_ Exam Sink —.—. Beer rep __.._ Eye Wash Stn ___-__-
Water Healer E"Prep Sink _____ :�oipper Well „_----- Deduct Meru ______
0 eas Cl Elect 0 PwrVnt Floor Sink -- Drink Fntn __ Wtr Sewer Mir __ _
C!ot)tes Wshr _—__ Hand Sink Wash Fntn Wit sge Mtr�_ __-_...__
Lour Tap- _ Lab Sink _ Catch Bastin —_. Miss i.ixtr.res
Electric Contractor (for projects not requiring an EIV Form)
Use/Nature of Work Hack- Ay' 74—(7 S- _ -T le1°' y Sc_,F..,c m , ----- --
r Size Material Type # 'Conn.Type —__�
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