HomeMy WebLinkAbout0152272 - Plumbing (dishwasher) CITY OF OSHKOSH No 152272
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2281 GOLDEN AVE Owner GENE M/SHIRLEYA SCHMIEDEL
Contractor BAUSCH PLUMBING Create Date 09/11/2012
Category 413-Res-Interior(Replacement Fixtures) Plan
Inspector Jerry Fabisch — ---
Bathtub -- Clothes Wshr Classrm Sink _
Surgeons Sink Roof Drain Deduct Meters
Shower Lndry Tray Exam Sink Sterilizer
Whirl pool — zer Soda Disp Wtr Sewer Mtrs ___
P Sump Pump _ F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory San Sump/Pump FIr/Wst Sink Bidet
Site Drain Misc.
Toilet 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
P _Comm Ice Maker
Dishwasher 1 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 _
Water
Use/Nature SFR/REPLACE DISHWASHER **check#27101 — —
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0617990000
Valuation <7 $113.00, Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided]
Issued By ,�1"^d1 Jl
Date 09/11_/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 1606 W HASKEL ST,STE A APPLETON WI 54914 -5032 Telephone Number 920-830-9222
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
PO Box 1130
Oshkosh,WI 54903-1130 ���
Phone:(920)236-5050
0
Fax:(920)236-5084
Plumbing Permit Application
I hereby apply for a permit m to do and install
the following plumbing on the premises hereinafter described,the
by said conform to the
Wisconsin State Plumbing Code,in the performance of which all parties hereto agree
can be brought to City Hall,Room 205 or mailed ton fees being doubled PO
r$100.00 1128, the
• Application(s)WI 4903-112) . work without permit(s)will result
WI 54903-1128. Commencing
normal permit fee,which ever is gr .
OR
1 ou are a c• rt !I • it
. • • , , 'ye add•date nd. c ec here
r•aet� ,
r ,ou want ti 's •• s ' • ti • . • • • • e I
Date � 2'
ts, L� la Value(Including labor and materials '�
Job Addresses - r" /114
r / / � Contractor Industrial
Owner A Rental ['Commercial ❑
Single Family ['Duplex ❑Multi-Family ❑
Number of Fixtures: Catch Basin
Drink Ftn
Bathtub Disposal Wash Ftn
Wait.St.
Whirlpool Dishwasher Urinal
Lavatory Sump Pump Ice Chest Gar Drain
Exam Sink
Toilet Ejector/Grind Soda Disp -
Sculry Sink
Res Sink Water Softner Coffee Maker
Hand Sink
Bar Sink Local Waste Comm.Ice Maker
F Prep Sink
Water Heater Clothes Wshr Site Drain
0 Gas 0 Elect 0 PwrVnt Bidet Sery Sink
Shower Beer Tap Int Grease Trap
Roof Drain
Ext Grease Trap Standp Rec
Floor Drain Classrm Sink Eye Wash Stn ---
Lndry Tray Surgeons Sink R.P.Z.Valve• Shame Sink Wtr Sewer Mtrs
Lab Sink Breakrm Sink Deduct Meters
Plaster Sink Dip Well FlrlWst Sink
Wtr Usage Mtrs
Sterilizer Hose Bibs
Misc.
Fixtures
Electric Contractor OR ['Electric Installation Verification form attach r
(If Replacement)•Use/Nature of Work ID-e-• I/ I.
Size Material Type
# Conn.Type
Sanitary Sewer
Storm Sewer
Water Service 1