HomeMy WebLinkAbout0155379-Plumbing (interior) �
� CITY OF OSHKOSH No 155379
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER -
Job Address 1736 W 9TH AVE Owner NC CONSTRUCTION Create Date 04/15/2013
Contractor JIM'S PLUMBING&HEATING INC _ Category 442-Commercial-Interior(New/Relocated Fiut� Plan
Inspector Jerry Fabisch
Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 1 Deduct Meters 0 °
Shower 0 Lndry Tray 1 Exam Sink 1 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 2 San Sump/Pump 0 Flr/Wst Sink 1 Bidet 0 Site Drain 0 Misc. 0
Toilet 2 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. 0 Fixtures
Kit Sink 1 Standp Rec 1 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 1 Int Grease Trap 0
Floor Drain 0 Bar Sink 0 Serv Sink 0 Wash Ftn 0 Ext Grease Trep 0
Hose Bibb 3 Breakrm Sink 1 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 1
Use/Nature OMM/CVS PHARMACY/Construction of a new store. State approved plans Trans ID#2201421
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
f
Water Service
Parcel Id#
0613170000
Valuation $16,000.00 Plan Approval $0.00 Permit Fees $144.00 ❑ Permit Voided I
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Issued By �'+5 Date 05/02/2013
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 W6166 GREENVILLE DR GREENVILLE WI 54942 -9676 Telephone Number 920-757-5258
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.
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05/02/2013 07:23 FA% 920 757 6482 JIM'S PLLJMBING �J001/001 `
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CiYy c�f ti�}�j;�cf�
lnspectic,n $ervices Divi;ion
1? OBox Il;f? �
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Plumbing Perrnit Applicafiion ON Tkf WATFR —
! hrr�.bv;�pl�. ior a penl�it ko d��and insta;l the folloti��ing piumbi�i�or, thc premis�s hereinafter desa iLecl,the«�ork to confonn to the
G1 i�cnnsin State Plutnbing Cod•�, in Tlte perforntance of v,�I,i�E; :;1 pai�ties liereto agre.e to and�irz �ound by said statutes,
'� App,���ation(s)and Pee(s) can be l,rou�!7t i��Ciiy f-lal1, f�oom �ii� er n2�iled to Inspec.t.ion Serviccs,.PO Box 1 128,Oshkosh \'v"I
::};iri;-i i��. L��»Inzncine«�c�r'h «�iti;o.i;permit(s)svill resulE izi f�..�s i�eing doubled ar`�100.00 pius the nornial perrnit fee,��hich
e,e��i> � �arer.
OR
/f ��,;� :���,� : cnrtir•actnrperrli�-f,��,,,, i�r 1he� Perr:ii! fc:� :-;_��c;;rrir S��s•tent anrl !a•>>•r ��•<eqira[e funds check litj,,
�' 4'Oif t:c7�7: ti11.S L7!'OC:E:S'S'L?CI G{11'�ii/ fl }�Q111' C1CCU7lF71 �
*�� Advisory- For applicable projects, an ElectricallnstalZatiozi Veri�cation(EI�') fonn, signed Uy the Electrical
Contractor or Homeowner(for installatioi�s atlo«ed ta be perfoz�ned by the]iomeo�;�ner) tnust be subruitted
witl�the �ei�nit application. Appiications si�bmitted ti�vitlioiit az� ��' when such is required, will not be
��rocessed for Permit Issuance and «�ill be reti�z�ied for cozt���tetioz�.
�()�) :�C�(�I'Cc� � � ��' y.1 �lr��► '/�v-s.. �'i1�11C �In_';,;lio;_�;3,;��r and materials�,l� G �'•�=` Date�I�/l..3
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��011tt'i�Ct(11' „1..�,'»� �c �,',�i�.�
�Singic: Famiiti� ❑lluplel L]iblr�tti-F�mily �
,_jRental �Commercial ❑Industrial
:�'UITt�JGI" 0��'1JitUi'CS:
?i:itliRih Sum Puttt? �
P 1 _ 1 :tcr Sirik Roof Urain
tih ,.., San �u;-i�t� ..:;P —� ti_...:;Icr�;';ink
� Soda Disp
Vliiri;;�:;r _ 1'�'a(cr�c,,...,
` . ..., _____._ •Smk Cot7ee!r4kr
I ivcun;,, _ � Staniipi;�e Rt;: __.L— ' .1 :Sink
' i Site Urain
��`"i�'� _ Z'" Garage.i D _._.`_ 5_�-_ec;r.s tiink W�itrs Stn
ir;tti;n� ,i Locai\":'c:stt
—_-- S:_ri#i�cr _„� Icc Chesl
i)is.��.��iil �_ S:ir Si�?:: _` �:i'Z`,';lve
Comm Ice M�ker
�iis!�•.c„�i��r _ Bre7k;:::•�in�: �__ �;cie: Int(�re,iseTrap
i 1��;�r 1:?�ain Classrn:Sinn _r::-�ai
- ' Lst Greace Trap
iioce isi;,i, `� 1=�am�i�:� _f E+�r: i ap r.:yo��'tuh Stn
'r'1�uer r;ca;�r �_ P f'rep 5irr: i�i�;e� �ot elt _ Deduct Moter
'!G.'r.i�f,E,lzc;_'P��-rVnt Plupr Sink �__ i?:i;i�:Fr,m
_� �vtr Sewcr Mtr
�'i�,ihc��t;hr i
i�nd�mk __. .._ �:trsh E=ntn
r.._, r VJIr l!sagc Mtr
:..n;h•. ,
. ---�— L��!?Si;ai; ,_ _c;tcn C3�±.in
�_ Misc Fixtures
I?Iectric Coritr.3ctor (for Projects not requiring �t� ETV Fot•m)
t�sc / N�iture of�i'�rI:
� Size Lfaterial T}p� # Co;�n, Type
j �anit;.;'4 Se«er
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� �roz'!n )el�,::r
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