HomeMy WebLinkAbout0154663 - Plumbing (install fixtures) CITY OF OSHKOSH No 154663
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1221 KNAPP ST Owner WINNEBAGO COUNTY GARAGE
Create Date 03/08/2013
Contractor WINNEBAGO COUNTY — — Category 442-Commercial-Interior(New/Relocated Fixti Plan
Inspector Jerry Fabisch_ — --
Bathtub 0 Clothes Wshr _ 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain
0 Deduct Meters 0
Shower
0 Lndry Tray 1 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 Flr/Wst Sink 0 Bidet
0 Site Drain 0 Misc.
Toilet 0 Water Softner 0
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
P _ 0 Comm Ice Maker _ p
Dishwasher 0 Local Waste 0 Sculry Sink 0 Drink Ftn 1 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 1
Water Heater 1
Use/Nature ICOMM/INSTALL FIXTURES IN FACILITIES SHOP AREA **check#81455983 1
of Work
1
L
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1307370000
Valuation $2,000.00 Plan Approval $0.00 Permit Fees $36.00 ❑ Permit Voided)
Issued By �� —
Date 03/0.8/2013_
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 wit in an easement,the City strongly urges the permit applicant to contact the
easement h. .- o se ur ecessary approvals before starting such activity.
Signature r, Date Wat I?
Agent/Owner
Address ; 54901 -97
E CTY RD Y OSHKOSH WI 54975 Telephone Number 232-1962
V — — —
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.
Pcl 6tt k l q Ccq K3
City of Oshkosh 36c"
Inspection Services Division
PO Box 1130 3(g`2ui3
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084 O�f l f IK�l/OJf l
f I
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 adequate funds. check here
ifvou want this processed through your account n
**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 (-TA( Kim' ST Value(Including labor and materials) act..“- Date '30i'( 1__
Owner (.f inn€L ( r Contractor J-y M r
['Single Family L jDuplex ['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 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 Comm Ice Maker
Dishwasher
Breakrm Sink Bidet Int Grease Trap
Classrm Sink Urinal Ext Grease Trap
Floor Drain (
Hose Bibb
Exam Sink Beer Tap Eye Wash Stn
Water Heater
1 F Prep Sink Dipper Well Deduct Meter
❑Gas WEiect❑PwrVnt Floor Sink Drink Fntn _i__ Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray -__LLab Sink Catch Basin Misc Fixtures
Electric Contractor (for projects not requiring an EIV Form) Cr/ Cc.6cTt�lc r
Use/Nature of Work cA 5(1-- --c M �f-�ct L I-ri CS ' Sif d' ui
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09