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Home My WebLink About2012-Plumbing (storm lateral) CITY OF OSHKOSH No 153261 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 2380 ABBEY AVE Owner GLENN J LEITH Create Date 10/30/2012 Contractor L G KIENAST UTILITY Category 401 -Residential-Exterior(laterals) 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 F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs Lavatory San Sump/Pump FIrWst Sink Bidet Site Drain Misc. _ -- Fixtures Toilet Water Softner Hand Sink Urinal Wait.St. 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 rS FR/Storm lateral to sump. of Work Size Material Type # Conn.Type Sanitary Sewer Storm Sewer 4" Plastic Lateral 1 New Water Service Parcel Id# 0613991600 Valuation $450.00 Plan Approval _ $0.00 Permit Fees $0.00 ❑ Permit Voided Issued By �C/"--- Date 10/30/2012 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 - Dat• C7 /' l 4., Agent/Owner Address 7 N WASHBURN OSHKOSH WI 54904 -7721 Telephone Number 920-231-0898 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 1-11111--11 iiiiihillIVI Phone: (920)236-5050 O�u�(0��-{ Fax:(920)236-5084 O IN THE WATER Plumbing Permit Application 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 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 11 **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 ETV when such is required, will not be processed for Permit Issuance and will be returned for completion. '� i��( Value (Including labor and materials) c.ti Date (V G ��er Job Address r / / / _ Owner C--l e A e e/ 1 Contractor h , 6 - /1-f nAJ CT/ 1 Single Family ODuplex ❑Multi-Family ['Rental ['Commercial ❑Industrial 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 Waitrs Stn Kit Sink Local Waste Sterilizer Ice Chest Disposal Bar Sink RPZ Valve Comm Ice Maker Breakrm Sink Bidet Int Grease Trap Dishwasher Ext Grease Trap Classrm Sink Urinal Floor Drain Eye Wash Stn Exam Sink Beer Tap Hose Bibb __ Deduct Meter Water Heater F Prep Sink Dipper Well__ Wtr Sewer Mtr ❑Gas❑Elect❑PwrVnt Floor Sink Drink Fntn 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 .s r tv■ `� 4-9 St/,".-,_� Size Material Type # Conn.Type Sanitary Sewer S itA/A A Cd Pic Storm Sewer Water Service 06/09