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Home My WebLink About0152251 - Plumbing (remodel bathroom) CITY OF OSHKOSH No 152251 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1930 SIMPSON ST -- Owner STEFANIE K GREEN Create Date 08/13/2012 Contractor MT.MORRIS PLUMBING _ Category 413-Res-Interior(Replacement Fixtures) Plan Inspector Jerry Fabisch Bathtub 1 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 Flr/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 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/Remodeling the existing bathroom to include replacing tub/shower valve **check#1007 of Work Size Material Type # Conn.Type J Sanitary Sewer Storm Sewer Water Service Parcel Id# 1409700000 Valuation � Plan Approval __ $0.00 Permit Fees $25.00 El Permit Voided Issued By 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 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 O Box 1130 Oshkosh,WI 54903-1130 Phone:(920)236-5050 Fax: (920)236-5084 0.f - o H Plumbing Permit ON THE WATER J 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 contra,, or participating in the Permit Fee Account System and have adequate funds, check here if you want this processed through your account f **Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signed or Homeowner(for installations allowed to be performed by the homeowner)mustdbe submitted with the permit application. Applications submitted without an EIV when such is required, will not be processed for Permit Issuance and will be returned for completion. Job Address n30 5\( t\ Si- Value (Including tabor and materials) "100 ,°O Date 1 Owner �� a �an\a v'c.c,� Contractor P .• i. ►C ' Single Family ['Duplex .•.• A 0 1� •• .t a ►r< u N.tovu P [,]Multi-Family ORental ❑Commercial il Industrial Number of Fixtures: Bathtub __J__ Sump Pump Plaster Sink Shower Roof Drain San.Sump/Pump Scullery Sink Whirlpool Qy Soda Disp Service Sink Coffee Mkr Lavatory Standpipe Rec Shamp Sink • Toilet Site Drain Surgeons Sink Waitrs Stn Kit Sink Local Waste Sterilizer Chest Disposal Bar Sink RPZ Valve Comm Ice Maker Dishwasher Brealam 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 0 Gas 0 Elect PwrVnt Deduct Meter Floor Sink Drink Fntn Wtr Sewer Mtr Clothes Wshr Hand Sink Wash Fntn Lndry Tray Lab Sink Wtr Usage Mtr Catch Basin Misc Fixtures Electric Contractor(for projects not requiring an EIV Form) Use/Nature of Work rq)\c ;140 1 4\ ey- U t'A\v.e Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service 06/09