HomeMy WebLinkAbout0153244-Plumbing VOID VOID VOID � CITY OF OSHKOSH No 153244
' OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD V O I D
ON THE WATER
Job Address 3026 JACKSON ST Owner 3026 JACKSON LLC Create Date 10/29/2012
Contractor 4 WAY CONSTRUCTION Category 444-Commercial-Exterior Laterals Plan K6-466-0212-P
Inspector Jerry Fabisch
Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 0 Lndry Tray 0 Exam Sink 0 Sterilizer 0 Soda Disp 0 Wtr Sewer Mtrs 0
Whirlpool 0 Sump Pump 0 F Prep Sink 0 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. 0 Fixtures -
Kit Sink 0 Standp Rec 0 Lab Sink 0 Beer Tap 0 Ice Chest 0
Disposal 0 Gar Drain 0 Plaster Sink 0 Dip Well 0 Comm Ice Maker 0
Dishwasher 0 Local Waste 0 Sculry Sink 0 Drink Ftn 0 Int Grease Trap 0
Floor Drain 0 Bar Sink 0 Serv Sink 0 Wash Ftn 0 Ext Grease Trap 0
Hose Bibb 0 Breakrm Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature OMM/exterior water and sanitary sewer laterals
of Work
�
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Size Material Type # Conn.Type
Sanitary Sewer 6"&4" Plastic Lateral 1 New
Storm Sewer
Water Service 1" Plastic Lateral 1 New
Parcel Id#
1519601600
Valuation $31,000.00 Plan Approval $0.00 Permit Fees $100.00 ❑✓ Permit Voided � PER CONTRACTOR
Issued By 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 P.O. BOX 133 BERLIN WI 54923 -0133 Telephone Number 920-361-1403
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 No 153244
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3026 JACKSON ST Owner 3026 JACKSON LLC Create Date 10/29/2012
Contractor 4 WAY CONSTRUCTION Category 444-Commercial-Exterior Laterals Plan K6-466-0212-P
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 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 Scully 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 COMM/exterior water and sanitary sewer laterals
of Work
Size Material Type # Conn.Type
Sanitary Sewer 6"&4" Plastic Lateral 1 New
Storm Sewer
Water Service 1" Plastic Lateral 1 New
Parcel Id#
1519601600
Valuation $31,000.00 Plan Approval $0.00 Permit Fees $100.00 ❑ Permit Voided
Issued By c. 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 se ent,the City strongly urges the permit applicant to contact the
easement holder(s)and to sec. - -I n ary -ppr., als befor- -rting such activity.
Signature i j67 Date /O'of /'7
Agent/Owner Jv
Address P.O. BOX 1 BERLIN WI 54923 -0133 Telephone Number 920-361-1403
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.