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Home My WebLink About2012 - Plumbing (dishwasher) CITY OF OSHKOSH No 152709 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1400 W 4TH AVE Owner JACK D PATCHAK Create Date 10/02/2012 Contractor BAUSCH PLUMBING -- -- — — -- _ Category 413-Bes-Interior(Replacement Fixtures) Plan Inspector Jerry Fabisch Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters Shower Lndry Tray Exam Sink Whirlpool Sump Pump _—. Sterilizer Soda Disp Wtr Sewer Mtrs p p F Prep Sink RPZ Valve Coffee Maker Lavatory San Sump/Pump FIrIWst Sink Misc.Usage Mtrs ___ Bidet __ Site Drain _ Mis Water Softner Hand Sink Urinal Wait.St. Fixtures --- Toilet WKit Sink Standp Rec Lab Sink Disposal Beer Tap Ice Chest P Gar Drain Plaster Sink Dip Well p _ _ Dishwasher Comm Ice Maker 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 Water Heater Eye Wash Statn Use/Nature SFR/REPLACE DISHWASHER "check#27145 of Work —Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# 0610580900 Valuation $113.00 Plan Approval —$0.00 Permit Fees $25.00 ❑ Permit Voided Issued By < ✓ i /1"Li Date 10/02/2012 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 P 0 Box 1130 Oshkosh,WI 54903-1130 . Phone:(920)236-5050 Fax:(920)236-5084 ot,C113;17r9 Plumbing Permit Application the following plumbing on the premises hereinafter and are described,the e by sat stotntesm to the I hereby apply for Sate Plumbing m to do and install t Wisconsin State Plumbing Code,in the performance of which all parties hereto agree PO Box 1128, brought to City Hall,Room 205 or mailed to Inspection doubled Pr$100.00 plus the • Oshkosh 49 fee(s)can be Commencing will result in fees being Oshkosh WI 54903-i 128. Commencing work without permit(s) normal permit fee,which ever is greater. OR , II . II , I , •y ade s uate und c tack here I ou are a contract, , 1 � � � e_ e, , . • � i •vtr want t r' j/ ..__.. Date /�� n' !/v . Value(Including labor and materials) - Job Address v 6 SG y��/�+�r G-f-riG>% l�� : Contractor Industrial Owner Rental ❑Commercial ❑ ❑Multi-Family ❑ [Y�'5ingle Family ['Duplex Number of Fixtures: Catch Basin Drink Ftn Bathtub Disposal St. Wash Ftn Whirlpool Dishwasher Wait. Urinal Lavatory Sump Pump Ice Chest Ex Sink Gar Drain Toilet Ejector/Grind Soda Disp Sculry Sink Res.Sink Water Softer Coffee Maker Local Waste Hand Sink Bar Sink F Prep Sink Comm.Ice Maker Water Heater Clothes Wshr Site Drain 0 Gas 0 Elect 0 PwrVnt Bidet Sery Sink [nt Grease Trap Roof Drain Shower Beer Tap Standp Rec Floor Drain Clessrm Sink Ext Grease Trap Lndry Tray Surgeons Sink R.P.Z.Valve Eye Wash Stn Shamp Sink Wtr Sewer Mtrs Lab Sink Breakrm Sink Wtr Sewer er Mt Plaster Sink Dip Well Flr/Wst Sink Wtr Usage Meters Sterilizer Hose Bibs Misc Fixtures Electric Contractor OR []Electric Installation Verification form attach( Of Replacement) Use/Nature of Work P-42- a A %._ ,/ L` i" Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service 11