HomeMy WebLinkAbout0154943-Plumbing (laterals) � CITY OF OSHKOSH No 154943
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 972 E SUNNYVIEW RD#12 Owner WISCONSIN MHP 6,LLC Create Date 04/04/2013
Contractor ABSOLUTE PLUMBING OF WISCONSIN Category 401 -Residential-Exterior Qaterals) 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 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 p
Disposal 0 Gar Drain 0 Plaster Sink 0 Dip Well 0 Comm Ice Maker 0
Dishwasher 0 Local Waste 0 Sculry Sink
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 Mobile Home/installing new water and sewer to new mobile home per code
of Work
I
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 Relay
Storm Sewer
Water Service 3/4" Plastic Lateral 1 Relay
Parcel Id#
1560000000
Valuation $400.00 Plan Approval $0.00 Permit Fees $100.00 ❑ Permit Voided I
Issued By •.��• Date 04/04/2013
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 N1473 ELLEN LANE GREENVILLE WI 54942 -9602 Telephone Number 920-757-7222
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Finat,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.
�ZE�EIVED
City of Oshkosh
,lnspection Services Division qpR 0 4 2013 �
P O Box 1130 �
Oshkosh,WI 54903-1130
Phone:(920)236-5050 ufP�+RTME'�T OF
Fa1c:(920)236-5084 '�o>���v�;,���ErcE�on�s o*� �I� V H
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OtJ tiF lt�/�7rR �.
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 aze 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 vou are a contractor aarticinatinQ in the Permit Fee Account Svstem and have ade�uate Junds check here
if vou want this processed throu�;h your account I—I
**Advisory-For applicable projects, an Electr7ical Installation Verification(EI�fomi,signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)mast be snbmitted
with the permit application. Applications sabmitted withont an EIV when snch is reqnired,w�l not be
processed for�Permit Issnance�nd w ed for completion
q7� L SK�ry ���v� �;��� /J
Job Address_�� Valne(���a�i���r�c��s> �� Dxte 7^,�� � .
Owner LV i Sc-o�S i ri m H� 6► �-�£ontractor I`J Sf�I� ��V�.�11�I If'1
�n le Family ODuplex QMulti-Family �Rental ❑Commercial ❑Indnstria
-��i I�e r L�o v�.� �o ri v��e �t- �eU..�-�r a y wo�C�
Number of Fiztures: �
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San.Sump/Pump Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Cof�'ee Mkr
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitrs Sfi
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve � Comm Ice Maker
Dishwasha Bieakm►Sink Bidet Int Grease Trap
floor Drain Classrtn Sink Urinal ��e�T�p
Hose Bibb Exam Sink Beer Tap Eye Wuh Sm
Water Heater F Prep Sink Dipper Well Deduct Meter
❑Gas�Elxt 0 PwrVM Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fnm Wtr Usage Mtt
L°d�'Tray Lab Sink Catch Basin Misc Fixtutes
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work �f�V1�ol.C-L`�` 5 t Vl1 '�� `J����f�2� Q y1ti�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09