HomeMy WebLinkAbout0155283 - Plumbing (install plumbing ) (.8D CITY OF OSHKOSH No 155283
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1535 SANDERS ST Owner LOREN R DIECK Create Date 04/26/2013
Contractor D R GLAZE PLUMBING _ Category 412-Res-Interior(New/Relocated Fixtures) Plan
Inspector
Bathtub 0 Clothes Wshr 1 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
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. 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 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 SFR\Install plumbing for owner supplied LT&ACW-(AAV)
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1305060000
Valuation )1 475.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By Date 04/26/2013
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1865 JAMES RD OSHKOSH WI 54904 -6873 Telephone Number 920-589-4014
—
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City of Oshkosh
Inspection Services Division
PBe
11:0
Oshkosh.WI 549ft-1130
Rhone t9d0):136-SO50 }.._.._..
Fa 9 _36-OS5 ( P K L ! F--1
Plumbing Permit Application
I h 6,appt;i fet a permit to do and bt#ail the folio,-Ina plumbing ea the pi ernises hereinafter ter e.escl-,be...the v.-oft,'to C0111.011,to the
Wisconsin State Plumbing Cede.ur the performance of which all parties hereto agree to and me bound by said statutes,
* Appilcaron s and fete-s)can be br ought to Cih Hall-Roam 205 orv<ailed to Ii pecti._t Se2IN-ice,.PO Box 11$ Os:ck ash WI
t-Nils-11:5. Comm enc Iits Rork without petm$i i toti11 result in fees being,doubled or S1 00l30 plus the normal perm 0 fee,which
teatet is n re'ere
OR
j
,-(t r . a t z 6,2 a e epgrr ag r-.e P r u,F. ccpun: $ ,7.,0,7,-,,,1.,,e a¢ g <,e_2.1.'6,3 c.ivek 41,e
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� �t(tor ,'N. s ^.aces ( htox� lo'Y 0(1COOi 0
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*'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 J "
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. 4+s-
Job Address IS_3s -5;tisAERS & Value tt„r:r abxmd .rrnal:'�I�/�= Date i 2q/202 9(3.-1/12; �/
Owner LorE f �i cC{< Contractor jS g /'kl(,.tgtn
[Olt:0e Family ❑Dtrplex L]Multi-Family Cliental ❑Commercial Industrial
Number of Fixtures:
na_.a„ ',amp Pump Pure Sick .-',t Dran-
San S,,mn?omP ,:till,zlrt node n,p
tt r...ni 0,trmei':euar ;=e Sisk 'Fee Via _...
on do p,item Skanp Sank ,rte Gran .......
I oi., k'ucce FD ,yn., a,_,,
S e5n:+: ecei hate Sit:ix-r
0,,a,tec 3r-:Uro S,uk 3.d_t t,,a,T1
F ,tx,n-, ca3,,„rnk ter.-al -tic,-aseTrap
',ate- c Prep Sc', D,ppe-ii'rk1 G e.111,Mr,,
71,.., Paint ,;:_ Dr ,..k Fncn --- `.5■s Sete e•-.,",
CI e' .,,, _..__i_..._ Han.1 Si,.F: Wash Fr.;
,Ict:T , __./_— tea.Sink _.v:Saw, 0,-Intern.
Electric Contractor for projects not reiquir an EIV Form) t / / / /'
Case Nature of�tiork s 1(q.— 4...3. FLM�-r s,.. i4 L-T-i- /`tCI.) `L� -it tv�..44v)
Size Islarenal T}pe a 00117.Tape
1
Sail liar;S=n-er
1
Stone Se.21
1a ater Sercrce
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