HomeMy WebLinkAbout0154569 - Plumbing (kitchen remodel) CITY OF OSHKOSH No 154569
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1040 BOWEN ST Owner DONALD W DINGELDINE/JULIE A RUSSO Create Date 02/27/2013
Contractor KOCH PLUMBING&HEATING INC Category 413_Res-Interior(Replacement Fixtures) Plan
Inspector Jon Mueller
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 0 Wtr Usage Mtrs 0
Lavatory 1 San Sump/Pump 0 FIr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 1 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. o
Fixtures
Kit Sink 1 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 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 0
Use/Nature SFR/replace kitchen and 1/2 bath fixtures, re-pipe kitchen drain.
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1108400000
Valuation $1,400.00 Plan Approval _ _ $0.00 Permit Fees $36.00 ❑ Permit Voided
Issued By ,TAM
Date 02/27/2013
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 2005 DOTY ST OSHKOSH WI - 54902 -7040 Telephone Number 920-231-6661 or 235
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.
SE.H .°N WV80 :8 'L •Pd "HL pni3a1
City of Oshkosh
Inspection Services Division
P O Box 1130
#4 .
Oshkosh,WI 54903-1130
Phone: (9 20) 236-5050 Oft JKJH
Fax: (920) 236-5084
ON_ WA1F t
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 adequate funds, check here
if you want this processed through your account piq
**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 /040 50,44,-_-.-,--- - 5-e- Value (Including labor and materials) /4`:.9`:"2" 1" Date 2—Z7—/5
Owner J61‘//z 2055 Contractor "d�/er eee r:".4
fSiagle Family ❑Duplex ❑Multi-Family ['Rental ❑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 hdkr
Lavatory / Standpipe Rec Shamp Sink Site Drain
Toilet __L_ Garage FD Surgeons Sink Waitrs Stn
Kit Sink / Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher / Breala-ra Sink Bidet Int Grease Trap
Floor Drain Ciassrm Sink • Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Stn
Water Heater F Prep Sink Dipper Well Deduct Meter
D Can❑Elect❑PwrVnt Floor Sink Drink Fntn Wtr Sewer Mr
Clothes Wslx Hand Sink Wash Fntn -7— Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work ,e.� f'-" ,-/Z.-----/ ," I ,� .,6 tr.7/,' ,d--/X7---1.4 ,,," , =4_- 19!x' t:� ii,.
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
❑ This installation is complete and may be inspected at any time.
06/09
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