HomeMy WebLinkAbout0152712 - Plumbing (kitchen / bathroom remodel) CITY OF OSHKOSH No 152712
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 356 W 19TH AVE Owner LC REAL ESTATE GROUP LLC _ _ Create Date 10/02/2012
Contractor REBMAN PLUMBING LLC Category 412-Res-Interior(New/Relocated 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 _ Sump Pump 1 F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory 3 San Sump/Pump FIr/Wst Sink Bidet _Site Drain Misc.
Toilet Water Softner Hand Sink Urinal Wait.St. Fixtures
Kit Sink 1 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/KITCHEN AND BATHROOM REMODEL 1
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1405480000
Valuation $80 .00 Plan Approval $0.00 Permit Fees $42.00 ❑ Permit Voided
Issued BySrn
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 W6013 BLAZING STAR DR APPLETON WI 54915 -7422 Telephone Number (920)257-6202
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
OIHKOM
Plumbing Permit Application ON THE WATER
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
I ou are a contractor •artici•atin.f in the Permit Fee Account S stem and have ade•uate unds check here
if you want this processed through your account f
**Advisory-For applicable projects, an Electrical Installation Verification(EIV)form signeby the
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted Electrical
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.
351P u-1
Job Address � u-1 /9 797 /9'� Value(Including labor and materials`9
�f�Q2�I CA2�2 C Dated a�I�
Owner Y Contractor Ref, 7) Pilin4,b? n
['Single Family ['Duplex / ['Multi-Family Rental ❑Commercial �dustrial
Number of Fixtures:
Bathtub Sump Pump
Plaster Sink Roof Drain
Shower San.Sump/Pump
Scullery Sink Soda Disp
Whirlpool Water Softener
Service Sink Coffee Mkr
Lavatory Standpipe Rec
Shamp Sink Site Drain
Toilet Garage FD
Surgeons Sink Waits Stn
Kit Sink Local Waste
Disposal Sterilizer Ice Chest
Bar Sink RPZ Valve
Dishwasher Comm Ice Maker
Breakrm Sink Bidet
Int Grease Trap
Floor Drain Classrm Sink
Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap
Water Heater F Prep Sink Eye Wash Stn
❑Gas❑Elect❑PwrVnt Dipper Well Deduct Meter
Floor Sink Drink Fntn
Clothes Wshr Hand Sink Wtr Sewer Mtr
Lndry Tray Wash Fntn Wtr Usage Mtr
Lab Sink Catch Basin
Misc Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type #
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
COLS