HomeMy WebLinkAbout0154886-Plumbing (eye wash station) � CITY OF OSHKOSH No 154sss
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1005 HIGH AVE Owner AXLETECH INTERNATIONAL INC Create Date 04/01/2013
Contractor OGDEN PLUMBING Category 440-Industrial-Interior Plan
Inspector Jerry Fabisch
Bathtub 0 Clothes Wshr 0 Classrtn 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 0 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site D�ain 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 1
Water Heater 0
Use/Nature IND/run water line to eyewash station
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0507610000
Vaivation $600.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided �I
��^
Issued By ,� t�"• Date 04/01/2013
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
AgenUOwner
Address PO BOX 689 NEENAH WI 54957 -0689 Telephone Number 725-8985
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.
03/28/2013 14:43 9207258984 OGDEN PLUMBING PAGE 01/01
Ciry of Oshkosh
Tnspection Services D;vision
P 0 Box 1130 �
Oshkosh,WI 54903-1130 �
Phona(920)236-5050
Fax:(920)236-5084 � �� �
Piumbing Perrnit Applicat�on ON 7NE WATER
�hereby apply for a pennit to do and install the following plumbing on the premise�hereinafter deacribed,the work to con�ornu to thc
�Visconsin Statc Plumbing Codc,in the performa�nce of which a11 parti�s hereto agrce to and are bo�md by said statut�es.
• Application(s)end fee(s)ean be brought to City Ha11,Room 205 or mailed to Inspection Services,PO�ox 1128,Oshkosh WI
54903-1128. Commencing work without permit(s)will result m feos beiing doubled or a100.00 plus the norrnal per�nit fee,whieh
ever�s greater.
OR
1 ou ar� a c �tract r arti ' alin rn e Permit e_e Account Svstem and hav� adeoua�e funds cheek here
+f_�ou want thrs processed thtough�ovr accaLnt
�
**Advisary-For a�licable pmjects, au EIectricel�nstallatio�Yerifieatio�n(EI�form,sigaed by t]xe Elecbdcal
Contiractor or$o�meowne�(for instal�ations allowed to be per�fo,cinned by t�e bomeownex)mnat be snbmitted
'with the perauit application. App�ications snbrnitted withoui an EN when sach is reqaired,will not be
processed for Per�ait 7ssna,nce and w�iIl be retarned for com�lction.
Job,A,ddress /D D�` � °`
5�" VA�llB(Including labor cnd metcrisls) �p n ` Date� ��.�
Owner J�- ��C`� Contractor Q .�da ��.b
❑Sivagle Famaly ❑Dupiex ❑Multi-Family ❑Rental
❑Commercia� �tndustrial
Number o��'i�ctur�:
�athtub 9ur"P pumD Plaqtcr Sink Roof Drain
Sh°`�`r San Sump/�umP Scullcry Sink Soda Di
�
�►�P�� Water Softrncr 5ervico Sink Coffm.lu�cr :
�"�►Y 5iaodpipe Rec Shemp Sink 5iu D�sio
Toila Ga�agc FD Surxcons SiNc Waitrs Sfi
Kit Sink Local Wastc Starilizer
Ia Cheat
Disposal Ber Sitak RPZ Valvo Comrn icc Maker
Dis6wsahcr Broektm Smk Bidet lttt Gteasc Trap
Ploor Drain Classrm Sink Urinel Ext drease Trap
Hose BibD Facem Sink � Hca Tap �ye 4Vesh 5tn �
Water Eiearer F Prep Sink Dipper Well Deducc Mctcr
C7 Gag 0 Elea❑PwrVnt ��g;f,k � Ddnk Fnb Wor Scwcr Mv
Clothcs Wshr H�d 5Wc Wash Fntn Wtc Usage Mtr
Lndry Tray Leb 5ink Caech Bnsin Miac Fixper�y
;lectric Contractor(for pz�ojects not requiurivag an EIV Fo�na)
Jse/Natnre of Work R� N ��,�..e.� l�� � �� �ya 1 �
Size Matetial Type # Conn.'�ype
Sanitary Sewer
Storm Sewer
Water 5ervice
06/09