HomeMy WebLinkAbout0155478-Plumbing (dishwasher) � CITY OF OSHKOSH No 155478
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2510 VILLAGE LN#A Owner SUSAN J LEFEBER Create Date 05/07/2013
Contractor WOLF&SONS PLUMBING LLC. 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 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 1 Local Waste
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 SFR/installing a dishwasher
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1320690000
Valuation $556.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided�
Issued By �^ Date 05/07/2013
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
descnbed in this permit application ithin an easement,the City strongly urges the permit applicant to contact the
easement hoider(s)and to secur any necessary approvals before starting such activity.
Signature � Date r " 7 � ��
AgenUOwner
Address 130 W.FRANKLIN AVE. UNIT#741 NEENAH WI 54957 -0741 Telephone Number 920-379-9772
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 � !
P O Box 1130 �
Oshkosh,WI 54903-1130
Phone: (920)236-5050 �
Fax:(920)236-5084 � �--�K�S�--�
ON THE WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described,the work to 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 brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI
54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which
ever is greater.
OR
Ij vou are a contractor participatin� in the Permit Fee Account Svstem and have adequate fiends check here �
if vou want this or•ocessed throu�h vour account I—I
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form,signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be snbmitted
with the permit application. Applications snbmitted without an EIV when such is required,will not be
processed for Permit Issnance and will be returned for compledon.
�/ �' /�'' �
Job Address '�"�_�� U'J/�1.� C/" /Y VaIUC(Including labor and materials)���� �• Date .��' � �1
Owner �F�� e� Contractor (���z� � SG^� � ���
❑Single Family ❑Duplex �Iulti-Family ❑Rental ❑Commercial ❑Industrial
�v
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San.Sump/Pump Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Coffee Mkr
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Crarage FD Surgeons Sink Waitrs Stn
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher � Breakrm Sink Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Sm
Water Heater F Prep Sink Dipper Well Deduct Meter
�Gas 0 Elect�PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fnm Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fi�ctures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work �/,J�`«i,,,U� �)(�'
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09