HomeMy WebLinkAbout0153461 - Plumbing (replace dishwasher) CITY OF OSHKOSH No 153461
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 75 LAKE REST AVE Owner MR/MRS THOMAS R WEIGT
-- — Create Date 11/08/2012
Contractor RAUSCH PLUMBING Category 412-Res-Interior(New/Relocated Fixtures) Plan
Inspector Jerry Fabisch — —Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain
— - Deduct Meters
Shower
Lndry Tray Exam Sink Sterilizer Soda Disp
ool - - — P Wtr Sewer Mtrs
Whirlpool Sump Pump _ F Prep Sink _ RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory San Sump/Pump FIr/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
P Comm Ice Maker
Dishwasher 1 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 DISHWASHER **check#27238 —of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1417090000
Valuation $113.00 Plan Approval $0.00 Permit Fees $25.00 El Permit Voided
Issued By
Date 11/08/2012
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 1606 W HASKEL ST,STE A APPLETON WI 54914 -5032 Telephone Number 920-830-9222 _
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 � 'lw��'
pO Box 1130 �N '�
Oshkosh,WI 2490341 0
Phone:(920)
Fax: (920)236-5084
Plumbing Permit Application
the premises hereinafter described,the work to conform to the
on th p, said statutes.
• plumbing antes hereto agree to des are d,the by
I hereby apply for a permit to do and install't the performance of which all p ox 1128,
Wisconsin State Plumbing action Services,P�B plus the
Application(s)and fee(s)can be Commencing brought to City Hall,Room 205 grim riledlton fees being doubled Pr$100.00 p
Oshkosh WI 54903-1 128. Commencing work without permit(s)
nd c eck here
normal permit fee,which ever is greater. �r ,Ve add,wale
OR u
au are a c, r r•actr , ' , . • •
1 • ' � Z
e,
ou wan tl is �J Date /�
5 l ° - . Value(including labor and materials) ;
Job Address (—�i` , ,
-e. Contractor Industrial
Owner �► �� Rental ❑Commercial ❑
(Single Family
[]Duplex UMulti-Family ❑
Catch Basin
Number of Fixtures: Drink Ftn Wash Ftn "
Disposal � Wait.St. --
Toilet Urinal
Dishwasher Ice Chest --- --
Lavatpool pump Gar Drain
Sump Exam Sink — --
Tovatory Soda rain
Ejector/Grind Setilry Sink
Res _ Coffee Maker
Water Soflner Hand Sink
Res.Sink Ice Maker
Local Waste F Prep Sink
Dar Gas Clothes Wshr — Soe Comm.m.Ice
---
Water Heater Seri Sink Roof Drain ---
❑Gas D Elect❑PwrVnt Bidet Int Grease Trap
Shower Beer Tap Standp Rec
Ext Grease Trap Eye Standp Re Stn
Floor Drain Classrm Sink R.P.Z.Valve
Lndry Tray Surgeons Sink Eye Sewer Mtrs
Shame Sink
Lab Sink Breakrm Sink DeducfMeters
Flr/Wst Sink
Plaster Sink Dip Well Wtr Usage Mtrs
Sterilizer Hose Hibs
Misc. attar i
Fixtures OR ['Electric Installation Verification form
Electric Contractor (If Repine Replacement) U v
r i
G _ ✓
Use/Nature of Work ' _ .
Type q Conn.Type
Size Material
Sanitary Sewer
Storm Sewer
Water Service