HomeMy WebLinkAbout0154818-Plumbing (food prep/hand sink) i
� CITY OF OSHKOSH No 154818
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1741 N MAIN ST Owner WILLIAM/PAULA TELLOCK Create Date 03/22/2013
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 0 Exam Sink 0 Sterilizer 0 Soda Disp 0 Wtr Sewer Mtrs 0
Whirlpool 0 Sump Pump 0 F Prep Sink 1 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 Fir/Wst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 0 Water Softner 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 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 COMM!Installing a food prep/hand sink. 1
of Work I
I
�
I
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1502440000
Valuation $1,500.00 Plan Approvai _ $0.00 Permit Fees $30.00 ❑ Permit Voided,
Issued By � Date 03/22/2013 .
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 hold )and to se ure any necessary approvals before starting such activity.
Signature Date :
AgenUOwner
Address 665 N MAI 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�JVnm v� � � v� vvnnuv�� snv� rv� •..n .... . . .� .. . .
City of O�sh ,
In�pcetian Scrvices Divtsi�n �
p O Box I 130 �
. Oshk,oeh,W't 5+4903•1130 •
�hoQae:(920)236-5050 - .
�ax�(9Z0)236-5OS4
Ptu�rt�i��g permit App�i�a�iQn
Y hereby spp}y for e pennit ta do�ond ina�ll the�bvv3ag plumbing an du�praaisa's h�neift�r+dasssib�d.t�e worlc to eonfc►rxn ta tlrc
Wisr,onsin�Ste►te�mnWng Codt,in Eb��et�orm�nce of whieb ali�ttir�htxato a��e ta a'�d ia'�e�bmu�d b'y aaid etaEutA�.
• �►ripHcac;u�(s)imd fEe�s)cea be brought to�Ay�11�nr�n 2�5�mx�l�d�to Iua�a�tio�Servicaa,�'�Btnt 1�ZB�Qshkosh'�II
54903-a 128. Co�oncing wark wlthaqE ger�it�s)�vHl ragwlt in fee�be�g�ubled or 5�00.00 plus tihe nort�f�perr�dt fex,which
m►er is greater, �
0�.
l e' �� i � � . a
t d.� r� u . t a t �
�'�A�[viso�-�ar�ieab��xo�e�,�a�E�e��I�t�lat�on'V'�ifitatie�n��f�m,a�tg�ad by t�e F:�t�f�u
�cfattact�,r o:�e�m�o�raer(for�talta�osia�owed m be��fm�nwl b.y th�lmtnaow�r)must be arxb�tt�ed
w�tl�tl�e pe�r epplicai3on. A�plieattons subynitl�ed�a+�h0ut a��'V'�hc,a s�xc�#a raquirad,will nnt�e
proceaaed fat P�it�asnc� w1I1 bo sah�ed for campl��mn. � �
� � ,�►��rl� „✓ : . . . ��a,�� �
Job Adtlr � � — . . �ue�noiva�et�,vr�►a,�.�:� �atc
.
,
O�aer _ _ _ � �ontractnr _ ;-._
��i6��'am�y ��3nplex M�t��i-�s�miIy [)Ren�a1 lCaYnmerCi�a1 Ytidt�s'tria�
N�mbcr of Ftxtur.�s:
e�m�ub Sum�Pump ,�,..�_ PluterSink � RoafD»in —
Shower ,• Sm.Sump/R��np Saulla�y�tnk � Sodt C�is�
Whidp�ol ,,,'.,�„_ W�Gx3oRener Savta�Sink Ccd�eMkr _,�
Laratory Stmdpipe Rec Sbtmp Slnk Site fltafe
ToDct (iara�e FD Sn�geo»s 3ink ��, 'Gf�dt�s Sin
Ktt Sink ,�� Locd Wasto SUerilitCr • ,,,,,,__ Ceo Cbest
Dlspos�l _ B�r$ink ItA�'�'iIYC GommteeM�er
bi�hw�ha gre�ktm Sink 'Bldet int�tt�p
Floor Dreta Clrsun►3ink �,.. C7rim( _� �xt arease'f tap
Hpss 81bb ���� Beu Tep By�!W�uh Sln
W�terHe�ta p PtoP Sink � � Dipper�Vcll DeA„et Melor
Q(i.�Q Bket dfwrrVM Floor 3ink .Drink�m Wtr Sewex�uitr
CIoN�wa Wslw �T1nd 3UOc �� Wuh Fetn Wt����
LndrylYey C,�bSink CetehBasin MisoPixto�w _r__,_,
lectr�c Co1�tt�acRor(�'b . o��cfis�ao ec�� ��E�`�'�orm) � :
�e/iV'�ture of'G�ork � ...
3iae 11�aterial T`ypo # , Conn.Type
.}
Sanitery�S�wer
3torm St�uver ' ' �
1�at�r Servlce �
.A'6/09