HomeMy WebLinkAbout0152630 - Plumbing (interior plumbing) CITY OF OSHKOSH No 152630
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2530 W 9TH AVE Owner WIHLM DENTAL Create Date 09/11/2012
Contractor JT SCHMIDT PLUMBING INC Category 442-Commercial-Interior(New/Relocated Fixti State Review
Inspector Jerry Fabisch
Bathtub Clothes Wshr 1 Classrm Sink Surgeons Sink Roof Drain Deduct Meters
Shower Lndry Tray Exam Sink 12 Sterilizer Soda Disp Wtr Sewer Mtrs
Whirlpool _Sump Pump 1 F Prep Sink RPZ Valve Coffee Maker 1 Wtr Usage Mtrs
Lavatory 4 San Sump/Pump Flr/Wst Sink Bidet Site Drain 2 Misc.
Toilet 4 Water Softner Hand Sink Urinal Wait.St. Fixtures
Kit Sink Standp Rec Lab Sink 2 Beer Tap Ice Chest
Disposal 1 Gar Drain Plaster Sink Dip Well Comm Ice Maker
Dishwasher Local Waste Sculry Sink Drink Ftn Int Grease Trap
-------- ----
Floor Drain 1 Bar Sink Sery Sink 1 Wash Ftn Ext Grease Trap
Hose Bibb 2 Breakrm Sink 1 Shamp Sink Catch Basin Eye Wash Statn _
Water Heater 1
Use/Nature COMM/WIHLM DENTAL/Interior plumbing associated with the new dental office
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0613620100
Valuation $27,595.00 Plan Approval $0.00 Permit Fees $238.00 ❑ Permit Voided)
Issued By �' Date 09/27/2012
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 LOCK;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.
City of Oshkosh - Inspection Services Division- Plumbing Permit Application Page 1 of 2
/ Division of Inspection Services
C,/hi C77"# 215 Church Avenue
P.O. Box 1130
Oshkosh,WI 54903-1130
i � FPahx ne(90 )2 350584 5
0 J7
PLUMBING PERMIT APPLICATION
SEP 19 2012
All information with * next to it must be provided. Incomplete applications will not be processed.
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.
If you are a contractorparticipating in the Permit Fee Account System and have adequate funds,type YES if
you want this processed through your account I
** Advisory- For applicable projects, an Electrical Installation Verification (EIV) form, 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 EIV when such is required, will
not be processed for Permit Issuance and will be returned for completion.
*30B ADDRESS 12530 West 9th street
*OWNER'Michelle A Wihlm
*CONTRACTOR 1J. T. Schmidt Plumbing GV4 1 cJ j/ S
*VALUE 1$27,595.00
*USE CATEGORY
r Single Family r Duplex r Multi-Family ( Rental r: Commercial r Industrial
Bathtub l Sump Pump 11 Plaster Sink 1 Roof Drain I
Shower I San. Sump/Pump [ Scullery Sink Soda Disp
Whirlpool F. - Water Softener 1" ® Service Sink 1 Coffee Mkr 1T
-
Lavatory J Standpipe Rec Shamp Sink J Site Drain l2
Toilet Garage FD Surgeons Sink J Waitrs Stn
Kit Sink Local Waste Sterilizer Ice Chest
Disposal 11 Bar Sink I RPZ Valve 1 Comm Ice Maker I
Dishwasher Breakrm Sink Bidet Int Grease Trap
http://www.ci.oshkosh.wi.us/Community_Development/Inspection Services/Permit App ... 9/17/2012