HomeMy WebLinkAbout0152723 - Plumbing (Kitchen maint) CITY OF OSHKOSH No 152723
OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER Create Date 10/03/2012
Job Address 3303 W 20TH AVE ---_--- ---
Owner OSHKOSH COMMUNITY YMCA
Category 443;Commercial-Interior(Replacement Fixtun Plan
Contractor JOHN E MEYER CO -----
Inspector Jerry Fabisch
Bathtub Clothes Wshr Classrm Sink Surgeons Sink Deduct Meters
Sur k Roof Drain
---- Wtr Sewer Mtrs
Soda Disp
- --- Sterilizer - -
Exam Sink ---"
Shower _ Lndry Tray - --
RPZ Valve Coffee Maker Wtr Usage Mtrs
Whirlpool Sump Pump --_ F Prep Sink --- Misc. _--_�.
Fixtures
Bidet Site Drain
San Sump/Pump FIr1Wst Sin _ — --
Lavatory
Toilet Water Softner 1 Hand Sink Urinal Wait.St.
-- -
Kit Sink Standp Rec Lab Sink Beer Tap Ice Chest
-- - —---
Dip Well Comm Ice Maker 1
Plaster Sink p ----
Disposal Gar Drain
Dishwasher Local Waste Sculry Sink Drink Ftn Int Grease Trap---
Floor Drain Bar Sink Sery Sink Wash Ftn Ext Grease Trap
-_p Catch Basin Eye Wash Statn---
Sham Sink
Hose Bibb _ Breakrm Sink --_ --- -—-
Water Heater steam generator
Use/Nature COMM/installing backflow protection and plumbing to fixtures
of Work
I
--- — Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1334100000
$0:00 Permit Fees $25.00 [1] Permit Voided
Valuation $450.00 Plan Approval — .0
Date 10/03/2012
Issued By - --
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.
Date
Signature
Agent/Owner
Address PO BOX 2783 OSHKOSH WI 54903 -2783 Telephone Number 235-2300
-------
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type
phof
Inspection(i.e. Footing, Service, Final,etc.),Access into Building if Secure(how do we gain entry),y our Name
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
(4)
Inspection Services Division
PO Box 1130
Oshkosh,WI 54903-1130 O�-�0��
Phone:(920)236-5050
Fax:(920)236-5084
RECEIVED
Plumbing Permit Application OCT 02 2O12
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter ddesc M' fom to the
Wisconsin State Plumbing Code,in the performance of which all parties hereto agree INSPECTION SERVICES DIVISION
• 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, check here
if you want this processed through your account n
�f B0
(,V , rN Ave Value(Including labor and materials) `5-D Date ql (12"
Job Address �� 3 _
Owner
�f Vt cA Contractor "1,'�t-I/J �� I. 'Eye IL (
OSingle Family CIDuplex DMulti-Family (Rental MCommercial nlndustrial
Number of Fixtures:
Bathtub
Disposal Drink Fm Catch Basin
Whirlpool Dishwasher
Wait.St. Wash Fm
Lavatory
Sump Pump Ice Chest Urinal -
Toilet Ejector/Grind Exam Sink Gar Drain
Water Softner I Sculry Sink Soda Disp
Res.Sink Local Waste Hand Sink Coffee Maker 1
Bar Sink
Water Heater
Clothes Wshr F Prep Sink Comm.Ice Maker
0 Gas 0 Elect 0 PwrVnt Bidet Sery Sink Site Drain
Shower Beer Tap
Int Grease Trap Roof Drain
Floor Drain Classrm Sink Ext Grease Trap Standp Rec•
Lndry Tray Surgeons Sink R.P.Z.Valve Eye Wash Stn
Lab Sink Breakrm Sink Shamp Sink Wtr Sewer Mtrs
Plaster Sink Dip Well Flr/Wst Sink Deduct Meters
Sterilizer Hose Bibs Wtr Usage Mtrs
Misc.
Fixtures C ltcaa.... C,,0 v c
Electric Contractor / OR I 'Electric Installation Verification form attach(
(If Replacement)
Use/Nature of Work _1-ti•<�-i--i 19c.e c_-ko v.-) cee e`c.,e'
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
11/