HomeMy WebLinkAbout2012-Plumbing (r& CITY OF OSHKOSH No 152559
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1022 WASHINGTON AVE Owner ROBERT B/DENISE M PREHN REV TRUST Create Date 09/25/2012
Contractor RAUSCH PLUMBING
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 Soda Disp Wtr Sewer Mtrs
Whirlpool - -
p Sump Pump F Prep Sink RPZ Valve
S Coffee Maker Wtr Usage Mtrs
Lavatory San Sum Site Drain Misc.
Sump/Pump FIr/Wst Sink Bidet
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 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 — —
Use/Nature SFR/REPLACE DISHWASHER **check#27131
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1100430000
Valuation $113.00 Plan Approval $0.00 Permit Fees $25.00 El Permit Voidecll
Issued Bye_
Date 09/25/2012
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 Divisiofax.P O Box 1130 I�
Oshkosh,WI 23 505030 OW
phone: (920)236
Fax:(920)236-5084
Plumbing Permit Application
on the premises hereinafter described,the work to conform to the
1 hereby apply for a permit m to do and install the following plumbing said statutes.
Plumbing Code,in the performance of which all parties hereto agree to and are bound by ox 1128,
Wisconsin State PI g action Services,PO B
• Oshkosh and can be Commencing to City
Hall,Room 205 r m�eedlt.Inspection
being doubled Pr$100.00 plus the
Oshkosh W1 54903-1128. Commencing work without permit(s)
normal permit fee,which ever is greater. c eck here
OR � . �t • Il , , , , •ve ode.uate tt
� �[ f
a u are a c► ttraet� r � .c � - u ■
i ou want I 'c" e'
'� Date -.'
I Value(Including labor and materials)
Job Address � / � - - /�
/�: Contractor Industrial
Owner — Rental ['Commercial ❑
[Single Family ❑DnPlex ,❑Multi-Family ❑
Catch Basin
Number of Fixtures: prinkFtn
Disposal ` Wash Fin
Bathtub _L Wait.St Urinal ---
Whirlpool
Dishwasher Ice Chest
Sump Pump Gar Drain
Lavatory ory Exam Sink
Toilet Ejector/Grind Soda Disp
ry Sink
Water Softner Scul Coffee Maker
Res Sink Hand Sink _
Bar Sink Local Waste Comm.Ice Maker
F Prep Sink
Water Heater Clothes Wshr Site Drain
Sery Sink
❑Gas Elect PwrVnt Bidet Roof Drain
Int Grease Trap
Shower Beer Tap Slandp Rec
Ext Grease Trap
Floor Drain Classrm Sink Eye Wash Stn
R.P.Z.Valve
Lab Sink Tray Surgeons Sink Wtr Sewer Mtrs• Shame Sink
Lab Sink Breekrm Sink Deduct Meters
FIr/Wst Sink
Plaster Sink Dip Well Wtr Usage Mtrs
Sterilizer Hose Bibs
Misr.
Fixtures
Electric Contractor OR ['Electric Installation Verification form attach(
of Replacement)
, ,,i) .
Use/Nature of Work a Ails
Size Material Type
# Conn.Type
Sanitary Sewer
Storm Sewer
Water Service 1-1