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Home My WebLink About0156063-Plumbing (laterals) � CITY OF OSHKOSH No 156063 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 3880 SHOREBIRD CT Owner KEITH ZIEBELULUANN DEBRUIN-ZIEBELL Create Date O6/07/2013 Contractor TOM VAN HANDEL CORP Category 401 -Residential-Exterior(laterals) Plan Inspector Jerry Fabisch Bathtub 0 Clothes Wshr 0 Classrtn 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 Whiripool 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. 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 Weil 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 Water Heater 0 Use/Nature NSFR/installing new sanitary sewer,water and storm laterals into house/all no metallic piping will have tracer wire of Work linstalled with it Size Material Type # Conn.Type Sanitary Sewer 4" Plastic Lateral 1 New Storm Sewer 4" Plastic Lateral 1 New Water Service 1 1/4" Plastic Lateral 1 New Parcel Id# 1281550000 Valuation $2,000.00 Plan Approval $0.00 Permit Fees $150.00 ❑ Permit Voided�; ��— Issued By � � Date O6/07/2013 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 ecure an necessary ap vals before starting such activity. c / Signature ��„� Date O '7 /3 AgenUOwner Address 1830 E EDGEWOOD DR APPLETON WI 54913 -7757 Telephone Number 920-735-1221. 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 Inspecrion Services Division � P O Box 1130 � Oshkosh,WI 54903-1130 Phone:(920)236-5050 Fax:(920)236-5084 (�j��( � `--t�� Oti TF{p 1VATFR � 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 I1'vou are a contractor narticioatiriQ in the Permit Fee Account Svstem and have adequate funds check here i�vou want this processed through vour account n **Advisory-For applicable projects, an Electrical Installarion Verification(EI�form, signed by the Electrical Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted with the permit applicaHon. Applications submitted without an EN when such is required, will not be processed for Permit Issuance and will be returned for completion. Job Address �� 0�� a Date 6 6 �3 ��.-11 �-/-- Va�UC(Including labor and materials)_ Owner ,��Bruih��%t�� Contractor ��I �•� /�i�� '� �,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 Garage FD Surgeons Sink Waitrs Sm Kit Sink Local Waste Sterilizer [ce 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 Watcr Hcatcr F Prep Sink Dipper Well Deduct Meter �1 Gas I:I Elect[1 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr Clothes Wshr Hand Sink Wash Fnfi Wir Usage Mtr Lndry Tray Lab Sink Catch Basin Misc FixNres Electric Contractor(for projects not requiring an EIV Form) Use/Nature of Work Size Material Type # Conn.Type Sanitary Sewer `�// ��'' y� Storm Sewer y�� P�� Water Service l� �� o� 06/09