HomeMy WebLinkAbout0153720 - Plumbing (dishwasher) CITY OF OSHKOSH No 153720
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1171 PARK RIDGE AVE _ Owner PETER M/ELLEN K MOLL Create Date 11/27/2012
Contractor RAUSCH PLUMBING Category 413-Res-Interior(Replacement Fixtures) 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 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 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#27277
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1222550000
Valuation $113.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By 077-76j Date 11/27/2012
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1606 W HASKEL ST,STE A APPLETON WI 54914 -5032 Telephone Number 920-830-9222
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection (i.e. Footing,Service, Final, etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Inspection Services Division (11311.10116 POB°" 1130 0
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084
Bing Permit Application to the
Plum said statutes.
e premises hereinafter described,bound by work to conform plumbing on th p fCe to and hereto agree PO Box 1128,
s.
permit to do and install the following of which an p Services, plus the
1 hereby apply for a p Code,in the performance ection 100.00
Wisconsin State Plumbing Hall,Room 205 or mailed to Inspection doubled or$
can be meught to City ermit(s)will result in fees being
• Application(s) and fee(s) Commencing work without p here
4903-1128. �v- ado, ate nd c ec
normal permit fee,which ever is greater.
normal p ,
OR �' ]
itrac � , � , _
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1 ouar•eac e Date
t 'Ott grant 11 t b` labor ials)
'�fr Y l sane(including )G 4 or mat
'— Industrial
,job Address /r Contractor Commercial ❑
Owner Y Li r []Rental ❑
�5ingle Family ❑
Duplex �� [Multi-Family
Catch Basin --
prink Ftn �— Wash Ftn --
Number of Fixtures: Disposal Wait.St. Urinal _-
bathtub Dishwasher Ice Chest -- Gar Drain
Whirlpool Sump pump Exam Sink Soda Disp
Lavatory Ejector/Grind Scurry Sink Coffee Maker
Toilet �— —
Water goftner Hand Sink , Comm.Ice Maker Res.Sink Local Waste
F Prep Sink Site Drain
Bar Sink Clothes Wshr --- Sery Sink ---
Roof Drain
Water Neater Bidet _
❑Gas❑Elect O PwrVnt Int Grease Trap Roof
Rec
Lndry
Beer Tap Ext Grease Trap Eye Wash Stn —
Classrm Sink R p Z.Valve —
Lab Drain We ashr Stn
Lndry Tray Surgeons Sink Shamp Sink —
Hreakrm Sink Deduct Meters —
Ste Sink FlrlWst Sink Wtr Usage Mtrs
Plaster Sink Dip Well ----
Sterilizer --
Hose Bibs
wrist.
Verification form attar
Fixtures OR []Electric Installation
Replacement)
Electric Contractor :� — <?
Use 1 Nature of Work 6.-- ") i' , i -
Size
Material Type 0
Sanitary Sewer Conn.Type
Storm Sewer
Water Service