HomeMy WebLinkAbout0154768-Plumbing (laundry tub) � CITY OF OSHKOSH No 154768
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 130 N KOELLER ST Owner HILGENBERG&ASSOC/RON&BARB HARMS"Create Date 03/19/2013
Contractor M P KELLY Category 442-Commercial-Interior(New/Relocated Fixt� 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
Whiripool 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. p
—-- --- _ _
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. � 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 Serv 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 OMM/ADD LAUNDRY TUB --check#12612 :
, of Work :
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0611520301
Valuation $540.0 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided �
Issued By Date 03/19/2013
In the performance of this work, 1 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
AgenUOwner
Address 665 N MAIN ST OSHKOSH WI 54901 -4431 Telephone Number 231-1750
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.
VGb. IJ� LVII IV.JUnIn vt � l v� vvn��.svn •u�� �v� avn ..•• . . .. • � . _
� City of Oshkash .
In�pccpon Scrvices Divtsian �
P O Box 1130 �
. Oshk,oah,'OV'Y 54903-113fl �
rihcme:(920)236-5QS0 � .
�ax�(920)236-50a4
_ /1 R
Ptwml�in� Permit Applica#iQn
T hereby app}y�or A pennit to do md i�stall the�llavv3�g pltt�nbing on dt�pramise�hectine,tt�r dessclb4d.tha wock to eonftum ta d�e
Wis�consioa Stt�tto Phunbio,g Code,in fho per�ormance of whiEb ali pa�l�txcto agre�e ta a�d�bot�nd by a�id dt�tut�.
i Applicetion(s)and fee(s)cen be brougflt to City H�11,Rarnn 205 nr m�tv Inspo�tion Servieaa,PO Bvx 1128,Qshkosh'WI
54903-�128. Co�nmanci�ug wark withvuk gerinit(s)wi�ll result in feea be;�g tlt�uMod or$1041.00 plus 1}�e nortrtul pem�it fe,e,which
tver is gxesur.
O�i.
! e� c. s � a t :: .s e 1 ,.a. s: d :
� o t .'s . d.t rou r a un� -
'"*Axtvlac+�-�or�pplic�bic�nroje+cts, �E��ctri�al Ingt�ll�vn''V'�at�on��f�irm,s�gnad b��e E:��trl�
�cinuacEat or�omeo�vaer(Por�tarst�ttat�ona allow�d m'be�+crfaxm�cd by fiba homa��ar)�tsast be ar�hrntaed
w�itl�the peimft applica�ion. Appli�ations su�b�nitc�ed�i�hout an�V`wh�n such#a raqu�r�d,will not�e :
proraessed far Pcr�ait Yaana�►c��and wi11 be scha�a�cY for c�rmglr�t�. �c���.@�
Jab A.ddr�-a.�,/C3O.�.—;.:. °�/ "���✓ �A�llt(�naludingl�bvra►dm�teiinls) � �JAtC -� � 73
'. 1 �
_ 1�.1�-� �ontractnr �. : ' ��
O�v�aex_�� ` - :
��t6gle�+'amily ��}nplex �N1ul�i-F�miY.y []�ental mer�ial Yuduatrial
Numbar of Fixtures:
H�rtnub SumpPump �_ PlasterSink RoofDnin �_
Shower ,• Sm.SumplR�mp Scultcry 31nk � 3od�D'►�p
V�hirlpeol � W�tv3oltsner Savia•Sink GoffEeMkr
LaYatoty StW►dplpe Rcc Sb1mp Slnk Site flnde
Toilct Gera�e FD Sntg�+s Sink Wu1rs Sln :
KIt Sink . Loc�{Waste Steriliter ,,,_„__ Cee Cbatl
Dispos►l _ B�r$ink R�'Wrlve CotnmfeeM�loer
bl�hwuha gro�ktm Sink '�1dat Int(hwr'Mp
Floor Droln Cl�Slnk �„_ C7rinaf T_ �xt arease'fcap
Hpss HIEb Bx�S� SeuTtp �W�sh SIn
W�ter Heeta P Prep Sfnk Dipper Well Deduet Melw
Q(�u p gkct t1 PwrVnt �loor 5ink � Drink Fnm Wtr Sevr«Mtr
CtotAesWshr �T1ndSWc ,T� WuhFncn WhUs,�eMtr
LndrylYeY ,�._ Y.ebSink CttchBtsin MisoPixtu�w
lectr�c Co�tra+etor(fb�r projects notxe u�`"xng��n�'1'�'�orm) �
�e/Nature of'GUork �
Siz;e Material Typo # , Gonn.TyAe
Sanitary Sewer �o
3torm Sewer '
�.J�%
Watet Ssrvica
A6/09