HomeMy WebLinkAbout0155760-Plumbing (sump pump) � CITY OF OSHKOSH No 155760
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1216 SHORTAVE Owner MOLLYA BUHROW Create Date 05/21/2013
Contractor DRUCKS PLUMBING&HEATWG CO INC Category 410-Residential-Interior 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 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 We�l 0 Comm Ice Maker 0
Dishwasher 0 Local Waste 0 Sculry Sink 0 Drink Ftn 0 Int Grease Trap 0
Fioor 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/WATER BACKUP SUMP PUMP `�debit acct
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1206150000
Valuation $1,000.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided �I
Issued By W Date 05/22/2013
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
Agent/Owner
Address 314APPLETON ST MENASHA WI 54952 -2318 Telephone Number 426-2654
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.
r ,
City of Oshkosh .
Inspection Services Division �
' P 0 Box 1130 �
OshkQSh,WI54903-1130
�tione:(920)236-5050 • •
Fax:(920)236-5084 1(���'�"�
�_1�11\L../�
ON THF.WATfR
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)wil]result in fees being doubled or$100.00 plus the normal permit fee,which
ever is greater.
OR
If vou are a contractor DarlicipatinQ in the Permit Fee Account Svstem and have adequate funds check here
rLYOU want this processed through vour account (1
**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)mnst be snbmitted
with the permit application. Applications submitted withont an EIV when snch is required, will not be
processed for Permit Issuance and wil1 be returned for completion. ;
Job Address �1/� ��'(,CK`#'— '�t{� VaIUC(Including labor and materials)� rQiSY} -`�-- Date ��1 -l
Owner r'�#��V �U��YO:�.1 Contractor MC � ��v��nnb .n
mgle Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
Number of Fixtures:
Bathtub Su�p Pump � Plaster Sink Roof Drain
Shower San.Sump/Pump Scullery Sink Soda Disp
Whidpool Water SoRener Service Sink Coffee Mkr
Lavatory Standpipe Rec Sham Sink
P Site Drain
Toilet Garage FD Surgeons Sink Waitrs Stn
Kit Sink Local Wastc 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 Stn
Water Heater F Prep Sink Dipper Well Deduct Meter
0 Gas D Elect�PwrVnt Floor Sink Drink Fntn WV Sewer MV
Clothes Wshr Hand Sink Wash Fntn WtrUsage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixmres
, �i �
Electric Contractor (for projects not requiring an EIV Form)
Use/Nature of Work t,.�a-���CCK-�A Sv,�,,,�Q pv, �
Size Material Type , # Conn.Type
Sanitary Sewer '
Storm Sewer
Water Service
06/09