HomeMy WebLinkAbout0155334-Plumbing (shower) � CITY OF OSHKOSH No 155334
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1965 HICKORY LN Owner MICHAEL S/GAIL KNIER Create Date 04/30/2013
Contractor KOCH PLUMBING 8 HEATING INC Category 413-Res-Interior(Replacement Fixtures) Plan
Inspector Jerry Fabisch
Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 1 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 2 San Sump/Pump 0 FldWst Sink 0 Bidet 0 Site Drein 0 Misc. p
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 Piaster 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 0
Water Heater 0
Use/Nature FR/REPLACE BATHTUB WITH SHOWER "debit acct
of Work � �
i
�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1526120000
Valuation $� Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided (
Issued By Date 04/30/2013
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 2005 DOTY ST OSHKOSH WI 54902 -7040 Telephone Number 920-231-6661 or 235
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 othervvise,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 Divisian
POBax1130
Oshkosh.4VI 54903-1130 :
P�ne: �920, z3�so5o o �ofh
Fax: (920)236-5084
o�.��=�v.�res
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the preroises hereinafier described, the work to conform to the
Wisconsin State Piumbing Code,in the performance of wlrich all parties hereto agree�to and are bound by said scamtes.
• Applicaaon(s)and fee(s)can be brougbt to Ciry Hall,Raom 205 or mailed to Inspecaon Services.PO Box 1128,Oshkosh WI
54903-1128. Commencing work without permit(s)wiFl result in fees being doubled or$100.00 plas the normal permit fee.�vhich
ever is greatec.
OR
1 u are a contractor artici atin in the Permit Fee Account S stem and have ade uate unds check here
i ou wa►rt tiris � cessed throu h our account
**Adviso=p-Far applicable projects,an El�cal Iastallation Verification(EI�fo�,si�ed bp the Electrical
Contractor or Homeowner(for iastallations aIIowed.to be pe�formed by the homeowner)mnst be s�abmitted :
with 2he permit appliration. Applications sabmitted without an EIV when sach is reqnired, will not be
processed for Permit Iss-ivance and will be retumed for completion
Job Address ���a5- f�/G'/Ef��Lk �i� Vallle (Indudingla6orandmatedalsJ . ��v Date Q '3v�/�
Owner � �C h��%�'L !�N I F/Z Contractor /�l�Gf� f��3 � � - .
�Single Family ❑Daplez ❑Malti Family ❑Rental ❑Comraercial �Industrial
Number of Fixtures:
Bathtub Sump Pump Plaster Slnk Roof Drain
Shower _J_ San.Sump/Pump Scallcry Siak Soda DisP.
Whirlyool Water SofLeaer Service Slnk Coffce Ivikr
L,avacary Z StandpiQe Rec Shamp 5ink Site Drain
Toilet Gazage FD Snrgeons Sink Wait�s Sm
Kit Sok Lo�i Waste St�ilizer Ice Chest ,
Daposal BarSink 12PZ Valve Cowa tce Maker
Dishwas6er Bre�S� Bidet Int G�se Tra;►
Flaor Drain Cla.�rrn 5'mk Urinal Ext Grease Trap
Hose B�bD Exam S�nk Beer Tap Eye 4Yash 5tn
Wacer Heaca F PRP S� Dipper Wel] Deduct Metec .
0 Gas D Ele�.-t e Pwrvrn Floor Sink Drink Fnm Wtr Sewer Mu
Clotdes Wsbr Hand Sink W�h F� Wtr Usege Mtr
Lndry Tray Lab Sinlc Catch Eastn ry ����5
Electric Conh�actor{far projects not requiring an LIV Form}
Use/Nature of Work ,�/�L/�G;i� ,$fr`T/-��`✓�s �v/TI� S�d��Fil
Size Material Type # Conn.Type
Sanitary Sewer �
Storm Sewer
Water Service
�This installation is comptete and may be inspected at any time.
06/09
L'd Z8Z09EZOZ6 yoo�{ e�us�el� �00�06 £6 0£a