HomeMy WebLinkAbout0154033 - Plumbing (RP valves ) CITY OF OSHKOSH No 154033
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 2725 JACKSON ST Owner MERCY MEDICAL CENTER OF OSHKOSH INC Create Date 12/27/2012
Contractor OGDEN Category - - --
--- -_ tegory 442-Commercial-Interior(New/Relocated Fixtr Plan
Inspector Jon Mueller
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Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain
--— 0 Deduct Meters 0
Shower 0 Lndry Tray
rY y 0 Exam Sink
0 Sterilizer 0 Soda Disp 0 Wtr Sewer Mtrs _ 0_
Whirlpool 0 Sump Pump 0 F Prep Sink 0 RPZ Valve 1 Coffee Maker
0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 Fir/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 0 Breakrm Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature 1COMM. Install RP Valve to comply with Hydro Designs Survey
of Work
L
Size — Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1219810300
Valuation $1,000.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By 711,-t
Date 12/27/2012
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.
Name OGDEN PLUMBING Date 12/27/2012
Address PO BOX 689 NEENAH WI 54957 - 0689
OSHKOSH
ON THE WATER Plumbing Permit(242900-100-0750-4378-00000) 11111111111111011111111111111111111111
Plan Permit Number 154033
Plan Approval Fee $0.00
Early Start Fee $0.00
Connection Fee $0.00
Fixture Fee $25.00
Re-inspection Fee $0.00
Fee Total $25.08
Check# Cash Amount Received $0.00
Received By jonm Date 12/27/2012
Account Balance 188.00