HomeMy WebLinkAbout0156008-Plumbing (cap laterals) � CITY OF OSHKOSH No �ssoos
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 421 523 OREGON ST Owner SIX RIVERS INVESTMENTS LLC Create Date 06/05/2013
Contractor D.R.HANSEN PLBG. Category 430-Industrial-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
WhiMpool 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. 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 Drain 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 Cap off sanitary and storm sewer laterals.
of Work
�
Size Material Type # Conn.Type
Sanitary Sewer 6" Vitrified Clay Lateral 1 Aband
Storm Sewer 10" Iron Lateral 1 Aband
Water Service
Parcelld#
0900010000
Valuation $2,000.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided j
Issued By �� Date 06/05/2013 �
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 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.
City of Oshkosh
lnspection Services Division � ,
PO68x1130 f� ) �)l^ �
Oshkash,WI 54903-1130 � v� � �
Phone:(920)236-5050 �
Fax:(920)236-5084 --� I�
Plunnbing Permit /�pp��r,ation UN TW�WqTCR
I hcreby apply for a p�rmit to do nnd inatall the followirig pfumbin�on the premises hcreinattcr de�ecribed,thc wc►rk to conform to the
Wiscpnsin State Plnmbing Codc,in f1�e perfi�tmance of whieh all patties hercto agroo to 8nd are(�pond by caid st�iutes.
• Application(s)and fce(s)can be brought to City Hall,Room 205 or mailed to Ins
S49Q3-J 128. Cornmrnci�ng wark witho�it permit(s)will result in fc:e�bcinR doubled or�00 OO�lus thB,��8,Oshkosh WI
ever ts�reator. D permit fce,afiich
OR
� or� a a antra or arlici alin "n [he ermi Fee cco 1 em a have ad uat �d che he►•g
i in l thi ro ssed lhrou ou� crcc ��
*y''A,dvisoxy-For ap�r�icable projects,ma Electrical�nstallation Vtr�i' tcatiop
Contr.lctoar ar Homeowner �oi' ��formt,�ed bJ the E�ec�icaa
( n�IlaNans allowed to 6e�erFobmcd by tfie homeow��r)must bc sabm�ited
w�th.e Pcr�it a�licat�on. Applicatinns submidacd wi�om an k1Y whea snch is ire
�nroce.ssed�o�t Pec�mit Issaance and w be retnr�ed foz comt�letiox�. '1°'x�,w�l not br
e� cJ 6��`
.Tob Address � Z`'� Valae r„�„am , o�
/ ( � nt,a�a m�rs) � bate � � 1
Owncr C� �Nl�f , _ Con�t�ractor , , �� )
�SNagle.Family �Dqplcx []Mniti-Fam' �"
�Y [�Rental []Commcrcial �iaa strial
Nubnb�r of Fioetnres:
�ilhtub g�r�P '
��r Pinster 3ink Rc�of Urein
Sa2 Sump/Pamp Scullery Sink
Whirlpool walw 8oitaicr �da Disp
�� Servic�Sink ����M�
k0n' Slundpipo Rx
'I"oilet ��� Shamp Sink Skc Thain
Klt 3ink SurAec►ns 5ink waitrs SM
Lnrnl Waece Stcrili�.ct
- Di9poxot Bar Sink fec Cheyt
RPZ Vplvc Canm Ite Malter
DiRhwaeher B�+eakrm SirJc Aidd
Inl Grense'�}ep
J°loor Drain Clue.qrm 5ink IJri�I
F.xt Gr�sC Trap
1•Iosc Bibb F�cam 9ie* Becx'Cap
.Wata Fkatcr F Pccp Sink byc WA'rh Sln
f.J Qas 1;151xt Cl 1'wrVnt �-- Dippor Wcll Decluct MctCr �`
Clotha Wshr F�'Sink brink Fnm `�
Hand 5ink • Wtr�o'MU
�ry�, . R+as!►rntn �. • Vvtr U
"�°Y Lsb Sink Cateh Bavin �P Mtr
• Misc Fixnitcs
Electric Contrgctor(for p�ojccts dot rcqu�ring an ��o��
Use/Natn re of Work C G� h i r �' �J� �� ) �.^ r
�� �C.,/ c� e
Size Mat�rial 7�,P� # ' _
_ _ Conn,Type
SanitAry Scwer '
Storm Scwer
Watcr Setvice
06/�9