HomeMy WebLinkAbout0154331 - (Plumbing ) replace fixtures) CITY OF OSHKOSH No 154331
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2131 FAIRVIEW ST Owner LYLE A/PATTY L SCHMITZ Create Date 02/04/2013
Contractor D.R. HANSEN PLBG. _ Category 413_:Res-Interior(Replacement Fixtures) Plan
Inspector Jon Mueller
Bathtub 1 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 2 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain _ 0 Misc. 0
Fixtures
Toilet 2 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. 0
Kit Sink _ 1 Standp Rec 0 Lab Sink 0 Beer Tap 0 Ice Chest 0
Disposal 1 Gar Drain _ 0 Plaster Sink 0 Dip Well 0 Comm Ice Maker 0
Dishwasher 1 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 1
Use/Nature SFR Replace existing fixtures.
of Work
i
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1521460000
Valuation $2,000.00 Plan Approval _ _ $0.00 Permit Fees $90.00 ❑ Permit Voided
T !,
Issued By J✓ \.. Date 02/04/2013
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 55 KNAPP ST OSHKOSH WI 54902 -3448 Telephone Number 233-1595
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 LOZZ 'ON WdSE Ol EIOZ l M aul;Lill. panic°a�
Inspection Services Division . . )
P O Btix 1130
Oshkosh,(920)236-5050 �f HK��H
Phone; (920)236-5050 • •
Fax: (920)236-5084 ON YHE 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 perinit(s)will result in fees being doubled or$100.00 plus the
normal permit fee, which ever is greater. .
ou are a contra for articisat'n_ ir the 'emit Fee ,account S st•m andHhave adeuat.e funds check here
Tf v
i nu want t is •ro .erred thro .h our •ccou t II •
F Datec '�'13
Job Address_ - Value (Including labor and materials) Hut b ' �
(_ Contractor O.° .1 I+� - P ` =
Owner �� . ,,, ._..., .. .
pu lex QMulti-Family . [Rental ❑CommirCiai ' industrial.•I
•
[�ivgle Family ❑ P
Number of Fixtures: ' FM Catch Basin
Disp.
isposal Drink F
Bathtub Wash
Dishwasher Wait,St. 17m Whir►pool Ice Chest � Urinal Lavatory la—. Sump Pump Our Drain _•r_
Ejector/Grind Exam Sink
Toilet Soda Disp
� Water Soither Scurry Sink .
Res.Sink __ Coffee Maker -
Local Waste Hand Sink
Bar Sink Comm.lee Maker
Clothes Wshr F Prep Sink
water Heater Site Drain
0 Gas C Elect 0 PverVnt Bidet Sery Sink
lnt Grease Trap Roof Drain
Shower Beer Tap Standp Rec
Floor Drain T__, Class=Sink Ext Grease Trap
RP2 Valve Eye Wash Stn
Lndry Tray. Surgeons Sink , . . Eye
Mtrs
Lab Sink 8reakrni Sink Shamp Sink
F1r/Wat Sink Deduct Meters
Plaster Sink Dip Wall Wu.Usage Mtrs -
Sterilizer �— Hose Bibs
Mire.
Fixtures
Electric Contractor OR DElectric Installation Verification form attached
(if Replacement)
Use I Nature of Mork_
414, cm- °J , w S
Size Material Type
# Conn.Type
Sanitary Sewer .
Storm Sewer
Water Service 11/o,