HomeMy WebLinkAbout0156353-Plumbing (laterals) � CITY OF OSHKOSH No 156353
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3778 GLENHURST LN Owner TIMOTHY REINKE Create Date O6/04/2013
Contractor ABSOLUTE PLUMBING OF WISCONSIN Category 401 -Residential-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
Whirlpool 0 Sump Pump 0 F Prep Sink 0 RPZ Valve
Lavatory 0 San Sump/Pump 0 FldWst Sink 0 Bidet 0 Site Drain 0 Misc. p
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 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
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\Mobile home to be set on existing site along with new 8'X 10'shed according to attached site plans. �
of Work Installer-Bob Becker-Manufactured Housing Specialists-142921 -11-21-2014
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 New
Storm Sewer
Water Service 3/4" Plastic Lateral 1 New
Parcel id#
Valuation $500.00 Plan Approval $0.00 Permit Fees $100.00 ❑ Permit Voided I
Issued By �k. Date O6/24/2013
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
AgenUOwner
Address N1473 ELLEN LANE GREENVILLE WI 54942 -9602 Telephone Number 920-757-7222
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 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084 O.IHKC��
ON iHE LVATER �
Piumbing 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.
RECEIVED
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI
54903-ll28. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the nJUNI�er�nj,t�g�,which
ever is greater. 4 [ I
OR
If vou are a contractor narticinatinQ in the Permit Fee Account Svstem and have adegua������ k here
�vou want this processed lhrou�h ,your account �I CO�t�fU�ITY DEVELOP�tEVT
INSPECTIO�SER�'iCES Dl�'ISIOV
**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)mnst be snbmitted
with the permit application. Applications snbmitted without an EIV when sach is reqnired,will not be
processed for Permit Issuance and will be retnmed for completion.
Job Address��V ��`(!/�S��VaIllC(Includinglaborandmaterials) ;��� Date b7�����
OwnerCiJ�.S��.�� /✓�i'J/°� GG� Contractor �13...C�✓�� /°L�U/�✓'��s
�ngle 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 Cof1'ee Mkr
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitrs Stn
Kit Sink Local 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
i
Water Heater F Prep Sink ___ Dipper Well ___.__ Deduct Meter ____
=1 Gas'�Elect C PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wu Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work�C�/G� //C� C4�j/'����7C/�
Size Material ' �pC� # Co�Type
Sanitary Sewer �J 1 U �! �'�� ��
f
Storm Sewer
Water Service ��,G� ��'f� [����'��� /��i W
I
06/09