HomeMy WebLinkAbout0152687 Plumbing (fixture replacement) CITY OF OSHKOSH
No 152687
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1040 N WESTFIELD ST
1 Owner EVERGREEN VILLAGE
Contractor J RASMUSSEN PLUMBING INC Category -- — ------- Create Date 10/02/2012
o
9 rY 443-Commercial-Interior(Replacement Fixtun Plan
Inspector Jerry Fabisch --- ----
Bathtub Clothes Wshr Classrm Sink
Shower Sterilizer Sink Roof Drain
1 Lndry Tray Exam Sink --- Deduct Meters
Whirl pool zer Soda Disp Wtr Sewer Mtrs
p Sump Pump F Prep Sink RPZ Valve Coffee Maker
Lavatory 2 San Sump/Pump FINW Bidet Site Drain Mis
st Sink Ws Usage Mtrs
Toilet ---- _ _ c.
2 Water Softner Hand Sink
Kit Sink - - _ Urinal Wait.St. Fixtures
1 Standp Rec Lab Sink
Dis osal 1 -- Beer Tap Ice Chest
p Gar Drain Plaster Sink Dip Well
-- ---- p Comm Ice Maker
Dishwasher
1 Local Waste Sculry Sink Drink Ftn
--- --_
Floor Drain Bar Sink Int Grease Trap
Sery Sink Wash Ftn Ext Grease Trap
Hose Bibb
Breakrm Sink Shamp Sink Catch Basin
Water Heater Eye Wash Statn
Use/Nature APT 316/FIXTURE REPLACEMENT **debit acct
of Work — --
L
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1608640200
Valuation
$4,000.00 Plan Approval $0.00 Permit Fees
arntij
$56.00 ❑ Permit Voided
Issued By — — --- — -
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 1914 GREENBRIAR TRL OSHKOSH WI 54904 -8887 Telephone Number
-- — (920)233-6747(wore
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.
09/30/2012 06:27 9202311289
J RASMUSSEN
Oshkosh, +ti@1y1 54903-7130 1L'�Sfol1 PAGE 01/01
P 0llox 1130
ihonei4( 10) :36-50 0
Phone:(92n)Z:its�soso
Fax (920)236_5084
S .1; r Plumbing Permit Application nn 71•1H invrer ::
1 hereby apply for a Permit to d�,and iDStali the following plumbing on the
apply for a permit
Plumbing Code, in the f o llo wing a of Which all
rties hei hereiree.to and ar b the work t<, art:cam to the
parties hertwln agree to and s�rr.hound .
• ApPlicatiatt(9)and fCL(s)can be brought to C`.iq,Hall.Room 205 or mailed to ins �said ctFttatcs.
54ppIic1 ion( )and Commencing n work roughs pection Services
ever is greater,
QCrittit(9)w+11 result in fc�a being doubled or t;IOO,AO plus thevrtoryn t pennik toc, hich
OR.
d,,('vo�r arse.,-g—c"trcL,2';T.�csTzlS.LpiAatxna ftt thP tc1' � ,' �
1..y4.Y...11).Q t�_.dh.1..i_,rncgg thrnu .9ur J� f�� unt Svstal>x A►�� t1e_�f�f>'Pi e JrZLJ(�£,
.x,.. .4+CG'Otlttl,_J_Jc ere
** Advisory-For applicable projects, an'Electrical Installation Verification(ErV)form,signed Contractor"or Homeowner(for instillations allowed to be perfommed.by the honnneowe err)must be.the lmniti d call
With t!llc permit application, Applications submitted.without:an EN when sla.c%is required, will not be
processed for Pe, nnO Issuance and will be returned for completion-
oo
9-3 /L,Tob Address o o. a, Wes P4-1-1 value(.Including Inbar and mMCdals) 9 _ 9-3 0-
_relit'71 LA. C®lnitra ctor > 1 I pp p � S v ,`;C[fiingle Family Draplex FjAttnini-Panally ❑Rental ❑Commerctal ❑Tad:strlal
Number of Fixtures:
limhhrh Sump Primp Plaster Sink
I -- Roof Drain
Shover SAM.Sump/Primp _� Scullery Rink -.--- _—
Stuta Disp
Whirlpool _ Water Softener Service Sink ---
2 - -""° Coffee Mkr
Lavatory __- __. Standpipe Roc, Shrimp Sink _._. _�
Z Site Drain
Vnpk. -. Garage ell �.. -
1 it:ink ( Surgeons Sink _,,__._ Waitre Stn _,
__. Focal Waste Stcrllim
Disposal _---- Bar Sink -_ 1t,F7,.Valve - -- _.—
Ice Maker
Dishwasher __t_,
Breaks-ail Sink ___-„_. BkICk _~_ lot Grew leap _--
Floor Drain _._-_. ammo Sink {Jrinet __.._ -. Fxt Grease Trap __.._.
rinse P,ihh __ F.�tam Sink Beer Tap _ +c Wash Spy _—__
U-atrr ilearc� 'Prop Sink -� hipper VUcll DrXhua Meter `_-^
C.(Pxs C'131ceei"11`uirtVnt. ilaor pink .--
--__ Drink rata Wtr Sewer Mir
Clothes W,Chr Tan Sink ~— °---
1 of Tray .__ ______ Wash Pam Wir Usage Mtr ...,__
-- Lab Sink Catch Basin
----. Misc Fixtures —
Electric Contractor(for projects not requiring an EiV Form)
Use/Nature of Work (- - .Q, - g/b ___________
-- --____,...,._____.- Sire•--.-- ,...__MaicriaT -,.1;- ___-�"...._.-
Ypc �' G'tanrl.Type
Sanitary Sower
Storm Sewer
water service
OF/Oo
Received Time Sep, 30. 2012 7: 15AM No, 1024