HomeMy WebLinkAbout0152455 - Plumbing (interior plumbing) CITY OF OSHKOSH No 152455
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3.555 MOSER ST Owner RONALD H/JANE K JOHNSON LLC Create Date 08/20/2012
Contractor JT SCHMIDT PLUMBING INC Category 440-Industrial-Interior Plan N2-478-0812-P
Inspector Jerry Fabisch
Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain 8 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 3 San Sump/Pump Flr/Wst Sink Bidet Site Drain Misc.
Toilet 6 Water Softner Hand Sink Urinal 2 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 4 Bar Sink Sery Sink Wash Ftn 1 Ext Grease Trap
Hose Bibb 3 Breakrm Sink _ Shamp Sink Catch Basin Eye Wash Statn
Water Heater 2
Use/Nature )ND/Interior plumbing associated with the new addition to the facility
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1519606400
Valuation $80,000.00 Plan Approval $0.00 Permit Fees $210.00 ❑ Permit Voided
Issued By 2T. Date 09/18/2012
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 419 S WASHINGTON ST COMBINED LOCKS WI 54113 - 1049 Telephone Number (920)788-7314
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.
Permit App Plumbing Page 1 of 2
City of Oshkosh
Inspection Services Division
P O Box 1130 S E P 1 8 2012
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax: (920)236-5084
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 contractor participating in the Permit Fee Account System and have
adequate funds, type YES if you want this processed through your account
Job I Value
Address A r E (Including labor 1 F41 000 j Datej 9//41/a-
and materials)
Owner Q,Ltd, r j Contractor 11-'1- c t1vvui1,}• ' 1,14. mt
Use Category:
C Single Family r Duplex C Multi-Family C Rental tmmercial
C Industrial I
- D t x-t ') y" _ pZ 1 do
Number of Fixtures:
•
Bathtub . Disposal Drink Ftn I.. I Catch Basin
Whirlpool 1 Dishwasher 1 r Wait.St. ( Wash Ftn 1 /
i
Lavatory Sump Pump Ice Chest
/j
�. ___ Urinal I, _.[!_
Toilet 1 6 Ejector/Grind Exam Sink Gar Drain
Res.Sink L Soft ner L. ._ _1 Sculry Sink I Soda Disp
Bar Sink 1 Local Waste 1 } Hand Sink 1 Coffee Maker
Water Heater I 'L
•
..._t
Clothes Wshr F Prep Sink Comm.Ice��'`
C, Gas C Electric __.. Maker 1 .....
t ' PwrVnt
Shower Bidet I 1 Sery Sink I Site Drain
. Floor Drain I Beer Tap t Int GTeraaspe I Roof Drain
Ext Grease S
Laundry Tray I----T Sink �� Trap Standp Rec
Lab Sink 1 i Surgeons Sink R.P.Z.Valve 1 Eye Wash Stn I
http://www.ci.oshkosh.wi.us/community_development/inspections/permit_app_plumbing_2... 7/8/2007
Permit App Plumbing
Page 2 of 2
Plaster Sink 1 ; Breakrm Sink Shamp Sink 1 Wtr Sewer
Mtrs
Sterilizer J Dip Well I Flr/Wst Sink Deduct I
Meters I
Hose Bibs L _3 Wtr Usage
Misc.Fixtures 1 I
Electric Contractor I_
Permits requiring an Electric Installation Verification form can not be processed by e-mail since both
the application and EIV form must be submitted together. You may print these forms and submit them
together by coming to our office, mailing them or faxing them together at 236-5084.
Use/Nature of Work! ..tt-Er.Ark)r 124- L4A4,
Size Material Type # Conn. Type
Sanitary Sewer 4"/4 Ct% o./4 1
Storm Sewer I I Lid PVC 1
Water Service Ae L 4rol,
•
6A 00 kr" kOlVV(`
..-
http://vvww.ci.oshkosh.wi.us/cornmunity development/inspections/permit_app_plumbing_2... 7/8/2007