HomeMy WebLinkAbout0155901-Plumbing (interior) /�''� CITY OF OSHKOSH No 155901
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 500 S OAKWOOD RD Owner MERCY MEDICAL CENTER OSH INC Create Date 05/04/2013
Contractor TWEET-GAROT MECHANICAL INC Category 442-Commercial-Interior(New/Relocated Fixt� Plan state
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 2 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 FIr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 0 Water Softner 0 Hand Sink 2 Urinal 0 Wait.St. 0 Fixtures
Kit Sink 0 Standp Rec 4 Lab Sink 0 Beer Tap 0 Ice Chest 1
Disposal 1 Gar Drain 0 Plaster Sink 0 Dip Well 0 Comm Ice Maker 0
Dishwasher 1 Local Waste 0 Sculry Sink 0 Drink Ftn 0 Int Grease Trap 1
Floor Drain 0 Bar Sink 1 Serv Sink 1 Wash Ftn 0 E�ct Grease Trap 0
Hose Bibb 0 Breakrm Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature COMM/Plumbing associated with the remodel of existing rooms into a coffee/sandwich shop
of Work
,�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld#
0613660000
Valuation $15,271.00 Plan Approval $0.00 Permit Fees $126.00 ❑ Permit Voided I
Issued By �.l�T'. 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 PO BOX 11767 GREEN BAY WI 54307 -1767 Telephone Number 920-498-0400
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 specifed 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.
RECEI�ED
City of Oshkosh
Inspection Services Division �
P o BoX i i3o MAY 2 4 2013 �
Oshkosh,WI 54903-1130
Phone:(920)236-5050 DEPART�IE:�T OF O ��O �
Fax:(920)236-5084 CO�7�Y1��r^��1E�-cL��p��EVT
iNSPECTI�)'•:S�Ri'SCES�1�,'iSIOV pN rHE wnTFR
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 ofwhich 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
If vou are a contractor participatinQ in the Permit Fee Account Svstem and have adeguate funds, check here
if vou want this processed through Xour account ❑
**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 submitted
with the permit application. Applications submitted without an EIV when snch is required, will not be
processed for Permit Issaance and will be retarned for completion.
Job Address Sab S e..�(r� 04 k WoO� W VaIUB(Including labor and materials� �5�27� � Date SI�� I 2 o t 3
Owner 1�,�,��4 M�d►�a� Contractor T�teet-(�t.�a� N�,t�e�,an;c.o►,l
❑Single Family ❑Duplex ❑Multi-Family ❑Rental [�Commercial ❑Industrial
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 Gazage 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 Stn
Water Heater F Prep Sink Dipper Well Deduct Meter
❑Gas O Elect 0 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink �� Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type # Conn.Type :
Sanitary Sewer :
Storm Sewer
Water Service �
06/09