HomeMy WebLinkAbout0156035-Plumbing (laterals) /� CITY OF OSHKOSH No 156035
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2849 HOMESTEAD DR Owner WILSON Create Date 06/06/2013
Contractor FREUND EXCAVATING Category 401 -Residential-Exterior(laterals) Plan
Inspector Jon Mueller
Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drein 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 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
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 New sanitary sewer and water laterals
of Work
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 New
Storm Sewer
Water Service 1-1/4" Plastic Lateral 1 New
Parcel Id#
Valuation $8,700.00 Plan Approval $0.00 Permit Fees $100.00 ❑ Permit Voided i
Issued By �►�^ Date O6/06/2013
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of shkosh has no a thority to enforce easement restrictions of which it is not a party, if you perform the work
described in thi p rmit application ithi sement,the ity strongly urges the permit applicant to contact the
easement hold r( )and to s@cure nece sary approval efore starting such activity.
Signature Date —�3
AgenUOwner
Address 3135 DELHI RD OMRO WI 54963 -9724 Telephone Number 920-685-2196
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not perFormed within two business days from the time the project is ready.
City of Oshkosh
Inspection Services Division �
P O Box1130 � :
Oshkosh,WI 54903-1130
Phone:(920)236-5050 .
Fax:(920)236-5084 O.IHKO H
� ON THE WATER -
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described,the work to conform to the
Wisconsin State Plumbing Code,in the performance of which all parties hereto agree to and are bound by said statutes.
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI
54903-1128. Commencing work without permit(s)will result in fees being doubled or$]00.00 plus the normal permit fee,which
ever is greater.
OR
I�'vou are a contractor participatin� in the Permit Fee Account Svstem and have adequate funds, check here �
�vou want this pi�ocessed throu�h 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 sabmitted without an EIV when such is reqnired, will not be
processed for Permit Issnance and will be returned for completion. `f :
Job Addres���/ �///CiS���VaIUC(Including labor and materiay����/v ' � Date ' �/�
Owner� Contractor �iQ��/1/� �q.�'���`�/�✓G
�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
Iavatory Standpipe Rec Shamp Sink Site Drain
Toilet Cmrage 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
❑Gas�Elect C�PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sirilc Wash Fnm Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Electric Contractor(for projects not requiring an EN Form)
Use/Nature of Work��LS/� IY���✓ S��(���/��.�j�
Size Material Type # Conn.Type
Sanitary Sewer y � P��C ���L ,y ��
Storm Sewer
Water Service /�t� �T� �����j `,fP'����-- /�/��,�'
l�/J i �.
06/09
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LOCATION: p'� ��CI ���7� ,5��'E3ct� �D. .� .
WORK DONE:�?���� ���v �•, •%�/� or1 ��i���7�c�� TAP c�� S
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SIZE: ��
CONTRACTOR:
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INV#: QTY: PARTS:
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—�
.S s�i 7 � � �' r� G� �
PERMIT#: � U
BI.ACKDIRT: YES �� ;
CONCRETE: YES �
DETAILS: -
GRAVEL: WORKERS�_J��
REMARKS:
r�errn�� �� 35� �
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