HomeMy WebLinkAbout0154413 - Plumbing (RPZ to comply) 0 CITY OF OSHKOSH No 154413
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 108 W NEW YORK AVE Owner OSH AREA SCHL DIST MERRILL
---- ----- --- - ----- - Create Date 02/11/2013
Contractor BASSETT MECHANICAL
- ---- -._- --_ -- Category 450-Industrial-Other Plan
Inspector Jon Mueller - - -Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters
Shower _
0 0
Lndry Tray 0 Exam Sink 0 Sterilizer 0 Soda Disp—- --- --- p 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 -_-_San Sump/Pump 0 FIrWst Sink - -
-
0 Bidet 0 Site Drain 0
Toilet 0 Water Softner --- --- 0 Misc.
0 Hand Sink 0 Urinal 0 Wait.St. 0 Fixtures
Kit Sink 0 Standp Rec 0 Lab Sink 0 Beer Tap
Disposal - - ------ P 0 Ice Chest 0
p 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 IIND. RPZ to comply with Hydro Designs survey.
-------- ---------------------
of Work
-- -------- Size - ---._I
Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1500680000
Valuation $1,500.00 Plan Approval __ $0.00 Permit Fees----- $30.00 ❑ Permit Voided
Issued By V
Date 02/11/2013
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 PO BOX 7000 -- KAUKAUNA -WI 54130 -7000 Telephone Number 800-236-2502==920-
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
P O Box 1 130
Oshkosh, WI 54903-1130
Phone: (920)236-5050
Fax: (920)236-5084 DJ] IKC)JI
Plumbing Permit Application r, WATER
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 adequate funds, check here
if you want this processed through your 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.
Merrill School
Job Address 108 West New York Ave Value (Including labor and materials) $15 0 0 . 0 0 Date Feb. 4 , 2 013
Owner Oshkosh Area School Dist Contractor Bassett Mechanical
(Single Family ❑Duplex ❑Multi-Family nRental ❑Commercial ❑Industrial
Number of Fixtures:
Bathtub _ Sump Pump Plaster Sink
Roof Drain
Shower San.Sump/Pump Scullery Sink
Soda Disp
Whirlpool Water Softener
Service Sink Coffee Mkr
Lavatory Standpipe Rec Shamp Sink
Site Drain
Toilet Garage FD Surgeons Sink
Waitrs Stn
Kit Sink Local Waste
Sterilizer Ice Chest
Disposal _ Bar Sink RPZ Valve 1
Comm Ice Maker
Dishwasher _ Breakrm Sink Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trap
Hose Bibb _ Exam Sink Beer Tap
Eye Wash Stn
Water Heater F Prep Sink Dipper Well
Deduct Meter
Gas 'Elect 1 PwrVnt Floor Sink
Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink
Lndry y Tra Wash Fntn Wtr Usage Mtr
Lab Sink Catch Basin
Misc Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
06/09