HomeMy WebLinkAbout2012-Plumbing CITY OF OSHKOSH No 153762
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3001 S WASHBURN ST Owner BFO FACTORY SHOPPES LLC Create Date 11/29/2012
Contractor JIM'S PLUMBING&HEATING INC Category 442-Commercial-Interior(New/Relocated Fixt 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 _ 2 San Sump/Pump FINWst Sink Bidet _ Site Drain Misc.
Toilet 2 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 2 Int Grease Trap
Floor Drain 2 Bar Sink _ Sery Sink 2 Wash Ftn Ext Grease Trap _
Hose Bibb Breakrm Sink _ Shamp Sink Catch Basin Eye Wash Statn
Water Heater 1
Use/Nature JCOMM/Oshkosh B'Gosh store/interior plumbing associated with the remodel of existing store
of Work
2d
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1329420000
Valuation $11,500.00 Plan Approval $0.00 Permit Fees $77.00 ❑ Permit Voided l
Issued By i ( — Date 11/29/2012
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 W6166 GREENVILLE DR GREENVILLE WI 54942 -9676 Telephone Number 920-757-5258
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.
11/29/2012 09:21 FAX 920 757 6482 JIM'S PLUMBING X001/001
Cite of Oshkosh
inspection: Se.rvices Division
Oshkosh. VN'I 54903-11-30
4
Phone: (1920) 236-5050 Oil Fax: (920) 236-5084 Oil IO/I I
ON THE WATER
Plumbing Permit Application
I hereby pi. 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, ill the performance of which all pa tICS 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-) 12g. Commencing work without permit(s) will result in fees being doubled or$100.00 plus the normal permit fee,which
ever is 'greater.
OR.
li Pon are contractor partlegoat i g in the Permit' ce ..-Iccurit System and hale adequate funds, check here
rf t ou this processed throes , ,.'our account
^"* 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 EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
7 °,�j
,Job Address .fir, / c ,--f^; c e i.-,;, Value itn..lud : 11 materials)+)Y• Ifs, (_'-z.) Date //,/ `f//2--
(lvvne.r �r= .f: Contractor .,,i r >vr ,t- , c>s_, ?F.—f7
Single Family Duplex Multi-Family LRental WCommercial TIndustrial
Number of Fixtures:
Bathtub ^_._ Sump Pump T.____— .,..._r Sink Roof Drain
Shower Sea.Sup , . Scutter, Bunk Soda Disp
Witiriltt-n'. W ster Sorter,;: - i- `.ae Sink Ii- Coffee Mkr
L.avatcr. Siand pi pt :e: Slump sins Site Drain
Toilet -s:.- Garage PD `,r_euns Sink Waitrs Stn
kit Sin: _ Local Waste ..._rMzr Ice Chest
Disposal _ Bar Sins: t 7 Valve Comm Ice Maker
Breakrn ink — Int Grease Trap
Flo m i7rai;; Classrm.Sink Lx.l Grease Trap
z Exam c:,,k E-teu.Tap
Hose Bib:, ___ �_..._. _.._- __.._ Eye Wash Stn
Water i ieate
I P .-Prep Sink ,e ,.ell Deduct Meter
Gas tN )get PwrV __o
nt Floor Sink rb t o;n — Wtr Sewer Mtr
Clothes ','.'<,_•r _ _. Hand Sink _ V.-.....l Oin Wtr Usage Mir
l.ndre T. _ Lab Sisk resin Misc Fixtures
Electric Contractor (for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type Conn. Type
Santien Se ter
Storm) Sewer
Water Service
Received Time Nov. 29. 2012 7: 44AM No. 1783