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HomeMy WebLinkAbout0154047 - Plumbing (interior work) ® CITY OF OSHKOSH No 154047 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 3660 JACKSON ST Owner BERGSTROM OLDS-CADI GMC TK-NISS INC Create Date 12/31/2012 Contractor OGDEN PLUMBING Category 442-Commercial-Interior(New/Relocated Fixt. Plan Inspector Jerry Fabisch Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0 Shower 0 Lndry Tray 0 Exam Sink 0 Sterilizer 0 Soda Disp 0 Wtr Sewer Mtrs 0 Whirlpool 0 Sump Pump 0 F Prep Sink 0 RPZ Valve 0 Coffee Maker 1 Wtr Usage Mtrs 0 Lavatory 0 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. 0 Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. 0 Fixtures Kit Sink 0 Standp Rec 0 Lab Sink 0 Beer Tap 0 Ice Chest 0 Disposal 0 Gar Drain 0 Plaster Sink 0 Dip Well 0 Comm Ice Maker 0 Dishwasher 0 Local Waste 0 Sculry Sink 0 Drink Ftn 0 Int Grease Trap 0 Floor Drain 0 Bar Sink 0 Sery Sink 0 Wash Ftn 0 Ext Grease Trap 0 Hose Bibb 4 Breakrm Sink - 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0 Water Heater 1 Use/Nature COMM\Interior work+correct cross-connection per hydro design report of Work Size Material Type # Conn.Type • Sanitary Sewer Storm Sewer Water Service Parcel Id# 1519605800 Valuation $1,000.00 Plan Approval _ $0.00 Permit Fees $42.00 Li Permit Voided Issued By Date 12/31/2012 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. 12/28/2012 15:18 9207258984 OGDEN PLUMBING PAGE 01/02 City of Oshkosh - Inspection Services Division- Plumbing Permit Application Page 1 of 2 Division of Inspection Services L_ . ,. <„ 215 Church Avenue P.O. Box 1130 Oshkosh, WI S4903-1130 I Fax (920) 236-5084 f j Phone (920) 236-5050 5 /7& _ 5/7 PLUMBING PERMIT APPLICATION All information with * next to it must be provided. Incomplete applications will not be processed. 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. • - - - •,:.,_: •9.,0 • � r- -. t '1 . - AI - . .A .m and have adeauate ..A . L •1, A - . 1• - . . L _ a. •, • • 1 • - _ • 1 AO, • l ** 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. *JOB ADDRESS• ?/41. 1'0 _. a_ �-ri *OWNER Be`7,5 1-7` ki *CONTRACTOR 9y e- t 2 A/J *VALUE (O0 O Q.--- o *USE CATEGORY 0 Single Family 0 Duplex 0 Multi-Family 0 Rental Commercial 0 Industrial Bathtub Sump Pump Plaster Sink Roof Drain Shower San. ; Scullery Soda Disp Sump/Pump : Sink Whirlpool Water Softener Service Sink Coffee Mkr Lavatory Standpipe Rec : Shamp Sink Slte Drain Received Time Dec. 28. 2012 3: 18PM No. 2000 http://www.ci.oshkosh.wi.us/Community_Development/Inspection_Services/Permit App... 12/28/2012 12/28/2012 15:18 9207258984 OGDEN PLUMBING PAGE 02/02 City of Oshkosh- Inspection Services Division- Plumbing Permit Application Page 2 of 2 Toilet Garage FD . Surgeons Waltrs Stn Sink Kit Sink Local Waste Sterilizer Ice Chest Disposal Bar Sink RPZ valve Comm Ice Maker Dishwasher Breakrrn Sink Bidet Int Grease Trap Floor Drain Classrm Sink Urinal Ext Grease . . . Trap Hose Bibb /I 3 Exam Sink Beer Tap Eye Wash Stn Water Heater / F Prep Sink Dipper Well Deduct Meter ❑ II Pwr Floor Sink ; Drink Fntn Wtr Sewer Gas Electric Vnt Mtr • Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr Lndry Tray Lab Sink Catch Basin Misc Fixtures *USE / NATURE OF WORK ©".cc_7E` C'1 o S S G.C771 4-e_e 74-7 'ell S p A. t /Vdi"p /3€S (9-/V p.-€100.--4 ELECTRIC CONTRACTOR (for projects not requiring an EIV Form) Size Material Type # Coni. Sanitary Sewer . .. .. ..._ Storm Sewer : Water Service I 'Submits ; Received Time Dec. 28. 2012 3: 18PM No. 2000 http://www.ci.oshkosh.wi.us/Community Development/Inspection_Services/Permit App... 12/28/2012