HomeMy WebLinkAbout0156366-Plumbing (2 hose bibbs) � CITY OF OSHKOSH No �5s3ss
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 651 FRANKLIN ST Owner RICHARD L SCHROEDER Create Date 06l25/2013
Contractor D R GLAZE PLUMBING Category 402-Residential-Exterior(other) Plan
Inspector Jon Mueller
Bathtub 0 Clothes Wshr 0 Ciassrm Sink 0 Su�geons 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 Urinai 0 Wait.St. � 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 2 Breakrm Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature SFR/Replace(2)outside faucets
of Work
I"'ck#1227"'
i
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0703090000
Vatuation $675.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I
issued By '�"j'�k Date O6/25/2013
In the performance of this work, I agree to perform all work pursuant to rufes 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 1865 JAMES RD OSHKOSH WI 54904 -6873 Telephone Number 920-589-4014
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.
City of OshkosL �
Inspection Services Division
P O Box 1130 � -
Oshko�,WI 54903-1130 �
P6one:(920)23b5050
Fax:(920)236-5084 ��--I
o�v rHi wn v�r a
Plumbing Permit Application
16ereby epply fm a peimit ta do and'mstall the folbwmg plumbing ou ihe premises hereioaNer described the wmlc to conform to tLe ��
W'ixwsm State Plumbin¢Code,in the perfoim�ce of which all parties hereto agree to aad are bound by said staNtes.
• App6caaon(s)and fee(s)c�be brought to City Hall,Room 205 m m ailed to[nspection Services,PO Box 1128,Oshkosh W I .
54903-1128.Commeacmg wodc withoot pelmit(s)will tesuh iv fees being dovbled or 5100.00 plus t6e normal pemit fee,wLich .
ever is greater.
OR
/f�ou are a contractor parnctnating in the Permit Fee Account Srstem and hare adequate(unds check here _ ��
if vou�cant this arocessed throu¢h vour account n ��
'•Advisory-For applicable pmjects,aa Electrical Installarioa Vetification(F.IV)farm,sig�d by the Electrical
Coatndar or Ilameowner(far in4tallatioas allowed to be peiformed by the homeowna)must be submitted
wrth the permit application. App6catbffi submitted wit6out an EIV whm such is:equired,wiII nat be �' l� l��
processod far Pecmit Issuance and will be retrrcned for campletion.
n �1�
Job Address � �/�K4 N �1—vatae��e��.ma�m�>�� t S Date � ` 3
Owoer �1c�C SUiTCeCQE(C Contractor �����4Zc �L.6�1'�gl1�lG � �^;�
�k F�ry ❑Dapkz ❑Mattl-Famlly pxnc� ❑Commercinl ❑�ean�r�ei
Number o[Fetams: �o j�� (��V 3
Bahtab Somp PmP Pluea Siok _ Roaf Dran ____
5►aa•n _ Sm.SomV�P ______ Sa0eY5dc .__._._. SodelhsP _____. .
Wy� _ Wxa Sdtma �+u� — �K�
L�.atary _ �dPP�Ra _ Sh�P Sok Sitr Drin _ ..
Tdtl _ GaageFD ___.._ SmgeaesSvk R'atrs� .___... -
G Sok Lacal Waae Stadiza _—__— ke CLest _._ .
Disposd __. Ba55mkk ____. RPZ�'slve ___.__ C�mlceMaks _.__. '
Die6aa�a ....._ Breatrm Smlc Bidet _ Int Gease Tap _ �
Fla«Ikdu ____ QsssmSink [:riod _ E:tGuuirap
H�B� �z Ex��� _ _ B�T� EY�a.�� RECEIVIED
a'raHwe� FYRPSivk 1NPP�+Wd1 ._ DeA�aMeta
Gs EI«� Pa.Vet Flon Siak D�mk Fvm .._____ Wtr SeRa\fer _ ___ -
_.——
❑a6n W�r _.._.__ Nad 5ek _ Wuh Fem Wtr Usage Ntr _ .
LsdyT�ay L�� �8�� �xF�� — JUN 2 4 2013 �
Electric Contrador(for pro ects not mqui g an EIV Fo�m)
Use/Natum o[Work ��c���� f>��d�t'G–t '�[ DEPARTAIE.`:7 OP
—� C0�1�4U\I'I'Y DEO'EL�.>���T
s;za Maerisl rype a conn.rype INSPECTIOV SERVICES i3`�'':StQv
Sani�ry Sew�er `
Stmm Sewer
Water 3ervice
06/09