HomeMy WebLinkAbout0155909-Plumbing (cap sewer & water) T
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� CITY OF OSHKOSH `
� No 155909
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1909 JEFFERSON ST Owner CITY OF OSHKOSH REDEVELOPMENT AUTHC Create Date 05/31/2013
: Contractor D.R. HANSEN PLBG. Category 401 -Residential-Exterior(laterals) Plan
Inspector Jon Mueller
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 Fir/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
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 Cap off sewer and water for demolition.
of Work
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Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 Aband
Storm Sewer
Water Service 1" Copper Lateral 1 Aband
Parcel Id#
1515250000
Valuation $500.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided�
Issued By Date 05/31/2013
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 55 KNAPP ST OSHKOSH WI 54902 -3448 Telephone Number 233-1595
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.
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lnspcct[on Servtccs bivision
P 0 Box 1130 �
Oshkosh, WI 54903-1130 �
t�hone:(920)236,5050 .
Fax;(g�i0)236-5084
' . Pl�mbin� Permit Application �T�M
.
I he�eby�p1Y�pt a petmit ce dd snd itts:�l�the foll4�ving plur�bing on the pr�mtses horei�Atber 4c�s�ribct(,Lh�wnrk to cartform ro the
�'Isc�nsin Su�cc Piumbing Code�in th�e perfotmsn�of whi�h all pe�ttks 4etetn a�e to�td aro bou�d by 68id st�tut�s,
• Appllcaiion(s�aod fee(a)csn b�brought to City Ha1J,Room 205 or mall�d to oA�
54903-I 1Z8. Gommcn�ieg vrork tvlthotrt prmnic(a)wi11 r�ul�in foe�be.Lng douh�or S100.0�1us thenptmal�pe�Q6h�ICh
�t i,gtoater. y�
OR
� rtic
1 � e t a! �r �.�[g
**Adviso�rp.Fot appfleab�e p�rojects,an E(ectni�s�l Ittstallgt�ost Vcrlfication(E�fozm�sl�ar.�I by tbe�lc�ical
Comm�c�r or k�nmeowner(�or nQSrtalla�i�ona allawrd ro bc pc�va�ed bT tbe homco�vn�x)muat t�c sabm�itted
w�tla thc perm�t applicat�'on. Appt�cartiea►s asbmitted ai�tont$n�XY when sach�S tcqw�ed, w71 not b�
pzoccssed for Pe�mit Issua�ce and wiII be retur�ed for eo.wpa�No�.
Job Addxcss `��1 �( �rs�
'� Value�tad�a�a�eor�, ��„�� D�tc 3� ��
O�vner �� �'�p D� �51,��1� Contxactor � .�,
�Singllc I�'amlilY QDnp��x [JMniti-F�rnil � v� � L--�
Y []Rcntal QCon►mercial [jLtd
Number of F���; .
e��hmb A�
Whlrfpoo� D�dAW�dtlet y� UrMJc An _...._ Ca�ch�asin ��
l.ava�er�• Samp Pnn�q '—`_.. 14�s.Sr. ,,,..r Wwch Pm ,.,,..,� •
7o11cr '� 'a��� �._.. Urina�
----- �ecrod(irtnd s,Xam Sink -
Rc�.Stnk Wp*cr 5o�or .--•.- Crr,4xia ,
EarSink �_ --.— 6colry 5ink �..�. S�do di�
].ocnl Wes� Hand Sink "�
lvnfer Nea�c , ClOihc�t1'shr �lt'ee Makrr
::Cn0 J Ekq J Pwf'm� -4— =P►'�P$ink Comm k!Mekor �r~
show.r 8� .--.—_ San Rlnk Site Dr.tie `~
Flovf br11m �^_ 9CCt'l�p [nt C�rpabe Trap w��� "'
""—' Cia�m Slnk �� .—..--- Rouf Drrde
�7 Tay —�—�— 6xt GRSec Trnp ' 8tm�elp Rea ��
Lab Slqk � 9nraeaas SIN; . R1�,Z.V�hc �T � �. 'i^
'�`� B�e9E'trt►S(ul: ---� �3'e V�'�A 5tn
Ploster SfGk -�� 5aan�q Sfik ' W!r Se�rerMrt� _~+
Steril�er ,�^ '��'a Well , F1r1Wlt5f�k i�
NoseB,'ba �----- GCOuctMet� .
'disc. Wtr(/aga Mn,�
Fi,w:es -�-----
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F,lectrie Contt�ctor(for projects not xoqaari�g pn �Zy Fo��
U�e/Natarc af Work � C�'�' �w�,� � w� l � Gy ��1; a
C f � � y�
" Si� Meter181
T� # Conn.'i�pp
I Senit,�ry Sewar
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j $E�17TI.SCWCr I
� WBtef Sor�lce �
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