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HomeMy WebLinkAbout2012-Plumbing CITY OF OSHKOSH No 153726 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 3285 S WASHBURN ST Owner BERGSTROM FOX VALLEY INC Create Date 11/27/2012 Contractor OGDEN PLUMBING Category 442-Commercial-Interior(New/Relocated Fixti 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 1 Coffee Maker Wtr Usage Mtrs Lavatory San Sump/Pump Flr/Wst Sink Bidet Site Drain Misc. 1 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 backflow preventer for beverage dispenser Use/Nature COMM/installing cross connection protection to be in compliance with the correction notice that was issued by Hydro of Work Designs Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# 1365010000 Valuation $10,510.00 Plan Approval $0.00 Permit Fees $25.00 Permit Voided j Issued By �. 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 PO BOX 689 NEENAH WI 54957 -0689 Telephone Number 725-8985 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. 11/27/2012 11:35 9207258984 OGDEN PLUMBING PAGE 02/08 Ci ty of Oshkosh-Inspection Services Division - Plumbing Permit Application Page 1 of 2 PO a OS 3t.. Division of Inspection Services Cif if Of ra"1111111) 215 Church Avenue P.O.Phone(9 Box 20)1130 236. Oshkosh, WI 54903-1130 ' f Fax (920) 236-5004 5050 f] PLUMBING PERMIT APPLICATION All information with * next to it must be provided- Incomplete applications will not be processed. I hereby apply for a permit Wto isconsin d Install State Plumbing Codeplumbing In the performance of which all parties hereto, the work to conform to the agree to and are bound by said statutes. ox Application(s) and fee(s) can be brought to City Hall, Room 205 or mai'led exult Inspect fetes being doubledBor 1128, Oshkosh WI 54903-1128. Commencing work without permit(s) 4 $100.00 plus the normal permit fee, which ever is greater. . YES i • Y .l�af?2 sed_ through tmar 411II1; funds. tune yo ** Advisory- For applicable projects, an Electrical Installation verification (EIV) form, signed the by the Electrical Contractor or Homeowner(for installations Applicat to ions ons suerfor ed without homeowner) must be submitted with the permit application, an EIV when such is required, will not be processed for Permit Issuance and will be returned for completion. *JOB ADDRESS 31:2 ■ ja Sn 6 yr,t' *OWNER' Se-f/7 5 t/`ocl *CONTRACTOR' i b ©/ a r *VALUE* /0 5//0 *USE CATEGORY C)Single Family C7 Duplex 0 Multi-Family '-)'Rental C 'Commercial 0 Industrial Bathtub Sump Pump . Plaster Sink Roof Drain San. ; Scullery Soda pis Shower Sump/Pump ! Sink p Whirlpool Water Softener ' Service Sink Coffee Mkr Lavatory Standpipe Rec Shamp Sink Site Drain http://www_ci.Oshkosh_wi.us/Cortmmunity_Development/Inspection_Services/Permit App... 11/27/2012 tx3 nup:irwww.w.usiL USU.4_wl.ua,L.1,...,t..l,itj�,r.,.....,r..,..--------r-------__ -.. ■ A. C2] City of Oshkosh - Inspection Services Division- Plumbing Permit Application Page 2 of 2 Surgeons waitrs Stn Toilet Garage FD Sink Kit Sink Local Waste Sterilizer Ice Chest Comm Ice Disposal Bar Sink RPZ Valve Maker• Int Grease Dishwasher Breakrm Sink Bidet Trap Ext Grease Floor Drain Classrm Sink Urinal Trap Hose Bibb Exam Sink Beer Tap Eye Wash Stn Water Heater F Prep Sink Dipper Well Deduct Meter U ❑ �-;PM- Wtr Sewer Floor Sink Drink Fntn Mtr Gas Electric Vnt Wtr Usage Clothes Wshr Hand Sink Wash Fntn Mtr• Lndry Tray Lab Sink Catch Basin Misc Fixtures *USE / NATURE OF WORK 2,v 5 In.II /?e ve✓ -e c4.,40_c k ,Phi c 4,77 Ca Free M h e'' • ZNS A, //( S' — fae wy er'^ , ,sue to i6 s a vwd site,P , TN S f-a// ce p it pi•es. s v�P a' c f e°r•$ , ,P.La) r-' ic o � L le. J, -", Ao S e ewe/S r^-4 IA k. P'(/,4 7, • ELECTRIC CONTRACTOR (for projects not requiring an EIV Form) Size Material Type # Con I . Sanitary Sewer Storm S • ewer Water Service Submit Reset Received Time Nov. 27. 2012 11 : 35AM No. 1758 htt„•/lwww.ai.nslikosh.wi.us/Community Development/Inspection_Services/Permit_App... 11/27/2012