HomeMy WebLinkAbout2013-Plumbing CITY OF OSHKOSH No 155089
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 155 N SAWYER ST Owner BRIGHTON PROPERTIES LLC Create Date 04/17/2013
Contractor RAUSCH PLUMBING Category 442-Commercial-Interior(New/Relocated F ixt 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 1 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 1 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 Scully Sink 0 Drink Ftn 0 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 0
Water Heater 0
Use/Nature COMM/ADD BATHROOM **check#27573
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0608770100
Valuation $2,400. 0 Plan Approval _ $0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By Date 04/17/2013
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
Agent/Owner
Address 1606 W HASKEL ST,STE A APPLETON WI 54914 -5032 Telephone Number 920-830-9222
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.
06/n?
RECEIVED
City of Oshkosh
Inspection Services Division APR 17 2013 �,
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920)236-5050 ��� ������
Fax: (920)236-5084 co�l��'' "`
INSPE - ':.! >ICES D ON 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 vQii are a contractor participating in th,?Permit Fee Account System and have adequate funds, check here
if you want this processed through your account [l
** 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 /55 .n,, c,�.. ,t„_. i. co Date 41-15--,3
Value (Including labor and materials) t(J Zrt-)„dt�
'.: J ' .-' "J:ex...,•l'.\
Owner ►'r.r;i<r treil4--..r ! S'>ne1 t Fos S 7.) Contractor —r:Al Rcr;.,sca Pl t. 4:,v,r1
I 'Single Family (Duplex (Multi-Family ['Rental 4Commercial `'I 'Industrial
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Scullery San.5wSump/Pump Y Sink Soda Disp
Whirlpool _ Water Softener Service Sink coffee Mkr
Lavatory
—1-- Standpipe Rec Shamp Sink Site Drain
1 o:.et
Garage FI) Surgeons Sink Waitrs Stn
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher
Breaknn Sink Bidet lot Grease Trap
Floor Drain Classrm Sink Urinal Fxt Grease Trap
i lose Bibb __
Exam Sink Beer Tap Lve Wash Stn
1V,rer Heater
F Prep Sink Dipper Well Deduct Meter
Gas 1 I Elect I 1 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn .`.,itr Usage Mtr _
Ln.lrv'fray Lab Sink Catch Basin Misc Fixtures
Electric Contract r (for projects not requiring an EIV Form)
Use / Nature of Work rpo,cs,J; ,,,,.A,.,r,>.^i,M
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
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