HomeMy WebLinkAbout2013-Plumbing (sump pump & crock) C
, � CITY OF OSHKOSH No 155876
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 925 SCHOOL AVE Owner JOSEPH R DEMLER Create Date 05/29/2013
Contractor INTEGRITY PLUMBING SERVICES 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 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 FIr/Wst Sink 0 Bidet 0 Site Drein 0 Misc. p
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 Drein 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
Use/Nature 'SFR/INSTALL SUMP PUMP AND CROCK *'check#2027
of Work
I
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0204190000
Valuation $80 .00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided'i
Issued By Date 05/29/2013
In the performance of this wo�lc, 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 pe i application within an easement,the City strongly urges the permit applicant to contact the
easement holder ) d ecure any necessary approvals before starting such activity.
Signature Date �� ( �����
Agent/Owner
Address 1208 S IRMA ST APPLETON WI 54915 -3921 Telephone Number 920-540-9910
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 54903-1 1 30
Phone:(920)236-5050
Fax:(920)236-5084 Of HKO H
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
�vou are a contractor participating in the Permit Fee Account Svstem and have adequate fi�nds, check here
�vou want this processed throu�vour account n
**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 submitted without an EIV when such is reqnired, will not be
processed for Permit Issnance and will be returned for compledon. �
�/ ( l �y , ,�ty� d
Job Address���) ��(/1�(� �"t�� Va�UC(Includinglaborandmaterials) �(�(1' � Date ��ZS'��3
Owner cf-ClnG� �� t� Contractor ^ � luvrLb� rc�S LL
❑Single Family ❑Du ez ❑Multi-Family ❑Ren 1 Commer al ❑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
L.avatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitrs Stn :
Kit Sink L,ocal 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
G Gas 0 Elect�PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fnm Wtr Usage Mtr
Lndry Tray L.ab Sink Catch Basin Misc Fi�ctures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work S��„�,� �a�,.. �i"oC� � ��.p ...�,5�-!f _
�T-
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09