HomeMy WebLinkAbout0155555-Plumbing (2 sump pumps) � CITY OF OSHKOSH No 155555
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 940 CHRISTIAN DR Owner RODNEY D MIKKELSON/LAINE B THOMPSON Create Date 05/10/2013
Contractor D R GLAZE PLUMBING Category 413-Res-Interior(Replacement Fixtures) Plan
Inspector Jerry Fabisch
Bathtub 0 Ciothes Wshr 0 Ciassrm 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 2 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 0 Drink Ftn 0 Int Grease Trap 0
Floor Drain 0 Bar Sink 0 Serv Sink 0 Wash Ftn 0 Ext Grease Trep 0
Hose Bibb 0 Breakrm Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature FR/REPLACE SUMP PUMP AND INSTALL BATTERY BACK UP UNIT '*check#1219 �
of Work ,
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service :
Parcel Id#
1250171200 :
Valuation $1,900.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided ;
Issued By W Date 05/10/2013
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 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.
� Cm�ot osiikosh �
. Innpection Sen•ic:s Dn�islon
P O Bos l l:r � -
O;l�,k�;h.lt"[Sd9�i-1liG
� Plro�e:�q_'[ 6�SpS� : �/� /
Fa..a��Jl' 5'OS# �_�1J�_f L�l�._�
Plumbing Permit Appiication
� i hzreb}appty iot a penr.=.t ia cto a�d m�ta:l the fot;on-�c yiui3,bing on the premi�s herv�.nafter v�esciibe3.il�e 5,rork ta�nfonn m d,e
� R'i:cor,sin Statz P;usb:ag Code.;n th-perf�nnance of�.��hich ail part'se�I�ereta azr��to acd are boi:ed b��_aid stanrtes.
• yppticnt oN.sj and fe�s'�i car,be broueht to Cih��HaC_Romn'_Oi or n;ai:ed to In,pz�tioai Sere;ces.PO Bos 1 l.�S.Osf�kosh 4t'I
� 53�i3-k i=S.Co�nmencum�3�m1;��-;c6out pzi�uit{s)«°ill result ir ize�bea��doublzdor Jt�iGAO plus ffie umiaal�-rmit fez,}.-Uich _
n�zr is�r°ater.
OR
1 i o(..��'c o�itrnetor po�ticrpsn re,-.g'_rhe Pe-,mit F�a 3cc�{r St.te.nr a � hare �dequpicJv etai er,,FCi l�ere
_.. _ ___
af}ot�u�p. i �.r�roccs h,_o ie iour�c�oa��T ❑ ,
*'�Advisoq�-For applicab(e projects,an Electrica(Installation Yerificafion(EIV)form,signed by the Electrical D � ��
Contractor or Homeowuer(for installalions allowed to be peif'ormed br the homeowna)mnst be submitted �4
with the permit application. AppGcatioffi submitted withwt an EIV when such is reqiuced,will not be �
processed far Pe�mit Issuance and u�ill be returned for completion. p� �
/e lo �t
JoU,�ddress���/..{��._ �'alue� �aop i�.:.�a�,��:;��i_iC-L3p�^ -- Date����—_.. ��
O,—n,�ner �������F�E�� Contractor Yl��sVfzE//.aG e—�/�r�
�m�le Famflt �Du��lei O�Iultl-Famll� ORental ❑Commerdal ❑Indastrlal J O
�umber of Fistures: �
��:or __ sn��r�F �__ ��:c,s;-s __ x��ic��, --
5;.-�.a ....... iari.$nsPR:m. ....... S�:ulla-,�`ink ..... .. :_d:i.D'p . .. -
� �:hinp..'.1 .__.._ R'a�s�::�ea^.. ......... Sa.;_zjir.: ....... t.:..�\s.}s ........ _.
- �:�-� _...__ S:andaiF''e� ..__._. SB.mcSink ___. Sr.eDrs. ._. ... ..
Itia _ ___ GmageFD __. Su..e:.,s 5� .. "�-sas�::, _ . ..
�a,��.K �rat c-n�- s�R�t:�� .__�-n
� D,:p�..d. .... 3a::ni ... �PZ':ai.�c ... Cc.c.r.'.r`.�;cc ........ �
�.F..�nJ�er ..... 3reaA:n Sin:. ..._ S�d-t ....._.-. ict G ca.-�r� .. ..... .
� F.o2U:en ....... CeuunGnF: .... i'"ned ...... =caC+-u,Trr,, ...._ ..
� H.,r3io;� . ._- .xar.�.5ink _.__ 3t�-aP .....___. c.e�'a.45[^ .
� ':,'.r..rFen�.. . .. FPr,p�v:� ___ Sh�eraett __'__ D:i�*\`.ecd- ___ �.
� C:as cte._; P-.r�n.t FloaSini: DrckFo;a n'>Sra�a\•.e . .
t ch R-N� _—_..... hmid ii;:k ... '�'a,h F��.r _.... �-:r!iaee V± _... �T _
. �n.d;�: . _ ,.ae cinl _.u..ai.�� �lis:Fivuies H ����T�
LI i
Elearic Contractor(Cor projects not requirina an ER' orru)
t;se'\atureo[l�ork L�Y�C� Sis.r�Pu...l d-^ � � � . MAY 0 9 2013
, - — —------ ------ �-
__ �—
� Size \Iaterzl T}pe = Conn T_�pe , ..
s�r,irar,seuer DEPART;IYE:lT�F
stom�Se;tier C0�1�IU\iTy TjE�' :
iNSPECTiO,YSgR�'i E�'�p��EVT
ttater senice CES D(�'iS10V