HomeMy WebLinkAbout0154297 - Plumbing (replace shower and valve) CITY OF OSHKOSH No 154297
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 208 210 BACON AVE Owner PEGGY RAND _ Create Date 01/29/2013
Contractor MT. MORRIS PLUMBING Category 413-Res-Interior(Replacement Fixtures) _ Plan _
Inspector Jerry Fabisch
Bathtub 0 Clothes Wshr _ 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 1 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 _ 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 DUPLEX(210 BACON AVE)/REPLACE SHOWER AND INSTALL NEW VALVE **check#1020&1021
of Work
T
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1518330000
Valuation _ Plan Approval _ $0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By ) Date 01/29/2013
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 W6115 COUNTY RD W WAUTOMA WI 54982 -7842 Telephone Number 1-920-765-0665
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
PO Box 1130
Oshkosh,WI 54903-1130
Phone:(920)236-5050 QO,�( I
Fax:(920)236-5084
ON THE WATER
Plumbing Permit Application
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$100.00 plus the normal permit fee,which
ever is greater.
OR !' ^
If you are a contractor participating in the Permit Fee Account System and have • 7 =' #ue t{nds. od ne hsu
if you want this processed through your account 11
JAN 2 3 Q013
- Advisory-For applicable projects,an Electrical Installation Verification(ETV)form,sig tgAhc- ecj ical
Contractor or Homeowner(for installations allowed to be performed by the horn en leriailindittd
with the permit application. Applications submitted without an EIV when such is reqUikeCTitill fiiitbe L J. :;
processed for Permit Issuance and will be returned for completion.
Job Address A10 i),C i C.o r Q.. Value(Including labor and, ice) r5O O.00 Date { I a$ 113
Owner ?can 2nnd Contractor c\Dcc 0 c CG,4rr.\ W ;sc,ot\s■n kk Vizi.ri.S 1/41A ii
[iSingle Family ODuplex OMulti-Family QReutal ❑Commercial Dludustrial .
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San.Sump/Pump Sculley Sink Soda Disp
Service Sink Cam Mkr
Lavatory Standpipe Rec Shrimp Sink Site Drain
Toilet _. Garage Fl) Surgeons Sink Waitrs Sin
Kit Sink _ Local Waste Sterilizer Ice Chest
Disposal Barr Sink RPZ Valve Comm Ire Maker
Dishwasher - Brealam Sink -Bidet
Int{!tease Trap
Floor Dahl Chelan Silk —._— Urinal – Ext Grease Trap
How:Iiilrb Exam Sink Beer Tap Eye Wash Stn _Y__--Water Heater _ F Prep Sink Dipper Well _ Deduct Meter
o Gas o Flea ri PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wir Usage Mtr
Landry Tray Lab Sink Catch Basin Mi4t:Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work rep\rIc(4 wawa-r c M► inS�CX\ 11\(,w v ck\ve..
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09