HomeMy WebLinkAbout0155665-Plumbing (sump pump) � CITY OF OSHKOSH No 155665
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 811 W 17TH AVE Owner DOLORES R MINARIK Create Date 05/14/2013
Contractor KURT ZENTNER&SONS INC Category 412-Res-Interior(New/Relocated Fixtures) 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 1 F Prep Sink 0 RP2 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 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
UselNature SFR/installed a water supplied sump pump without a permit"'late fee added to permit*'*
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer .
Water Service
Parcel Id#
1409960100 :
Valuation $500.00 Plan Approval $0.00 Permit Fees $130.00 ❑ Permit Voided I
Issued By ��_ Date 05/16/2013
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 2860 OREGON ST OSHKOSH WI 54902 -7136 Telephone Number 235-1340
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 Div'tsion �
P O Box 1130
Oshkosh,WI 54903-1130
Phone:(920)236-5050 ul,\/1
Fax:(920)236-5084 � � �•�
QN F:��'rVnTFR ..
Plumbing Permit Application
(hercby apply for a permit to do and install the�foltowing plumbing on the premiscs hereinafter described,the work co 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 broughtto Ciry Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI
54903-1128. Comtnencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which
evei'is groater.
OR
! ou are a ntrac! r arli i atiri in !he ermit ee Acc unt S terri an have de uale und check here
; ou wanr this rocessed throu l+ our acco�nt
**Advisory-Fo�applicable pmjtcfs, an Electrlc.al Inst�tion Verification(E�foYm,signed by tht ElecTnical ;
Cont�ractor or I3omeowner(fox inst►llations a�owed to be pe�'ormed by the homev'wner)mttst be snbmitted
with the petmit appli►cation. Applications subrnitted withoat an EIV when snch is�reqnit'ed,w�71�ot be
processed fox Permit Zssnance and vvy71 be retarned for comp�etion. �
J�ob Address / �/• / �� VSllle(InCludingleborandmx6e�al5). ��'� )ate� /,5—` �.3
O�Wper
� Contractor �� J��
�Single Family ❑Daplex ❑Multi-�amily []Rental ❑Commercial �lndustrial
Number af Fixtares: �� �
W��/�� Plaster Sink Roaf Drain
Bathtu6 SOmP Pum�l _
Shower 5an.Sump/PumP Scullery Sink Soda Aisp
Whirlpooi
Wacer So�� Service Sink Coffee Mkr
l,ava�o Srandpipe Rec Shamp Sink Site Drain
ry
Toilet Catage FD Surgeone Sink W�'�S�'
Kic Sink Local Waste Sterili2er Ice Chesc
Disposal Bat Sink RPZ Valve Comm ICe Maker
Dishwasher
Br9ala'm S[tlk Bi6et Int G�c'easC'frep
Classrm Sink Uritmal F.xt Grease T�ap
Floor D�ain �Ta Eye Wash Sm
Hose Bibb Exam Sink p
Wa�er Heater
F Prep Sink Dipper We11 Deduct Meur
�Gras a Elec[0 Pwrvnt Floor Sink Drink Fnm Wtr Sewer Mtr
Clot�es Wshr Hand Sink Wash�nm wv Usage Mtr
Lndry Ttsy Lab Sink Cetch Hasio Mist Fixtures
Electric Contractor(for projects not requiring an EN Form)
Use/Nature of Work /����� � �a�''^��'l �v�"'� �-°�
Size Material Type # Conn.Type
Sanitary Sewer
Stocm Sewer
WaxCr Servicc
06/09