HomeMy WebLinkAbout0153247 - Plumbing (replace bathrub) CITY OF OSHKOSH No 153247
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 885 W 19TH AVE Owner JOHN J WIELAND Create Date 10/29/2012
Contractor MT.MORRIS PLUMBING Category 413-Res-Interior(Replacement Fixtures) Plan
Inspector Jerry Fabisch _
Bathtub 1 Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters
Shower Lndry Tray Exam Sink Sterilizer Soda Disp Wtr Sewer Mtrs
Whirlpool Sump Pump F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory San Sump/Pump Flr/Wst Sink Bidet Site Drain Misc.
Toilet Water Softner Hand Sink Urinal Wait.St. Fixtures
Kit Sink Standp Rec Lab Sink Beer Tap Ice Chest
Disposal Gar Drain Plaster Sink Dip Well Comm Ice Maker
Dishwasher 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/REPLACE BATHTUB-REBATH **check#1012
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1412430000
Valuation $550.00 Plan Approval __ $0.00 Permit Fees $25.00 ❑ Permit Voided]
Issued By aYntii Date 10/29/2012
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 W6115 COUNTY RD W WAUTOMA WI 54982 -7842 Telephone Number 1-920-765-0665
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 0/1-1K0 fH
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
54903-1128. Commencing work without permit(s)will result in fees being doubled r$100.0p Services,then 1128,Omit fee,WI
ever is greater. P permit fee,which
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed throufh your account El
**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.
Job Address< 5 W \%An NC, Value(Including labor and materials) j U ,v' Date , . 1
Owner `A /�
Jdh0 �")afLi �z,P oAck Contractor Lot..'1 t7- lfa W MS I.,-:&m \ M-)- PtbAr,5 v
Single Family ['Duplex [IMulti-Family ['Rental Commercial Industrial
Number of Fixtures:
Bathtub __1___ 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
Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher Breakrm Sink -Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Stn
•
Water Heater F Prep Sink Dipper Well Deduct Meter
0 Gast]Elect 0 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin
Misc Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work (Re 0(1_a 1pa N)�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09