HomeMy WebLinkAbout0156386-Plumbing (separate water) � CITY OF OSHKOSH No 156386
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 343 W 16TH AVE Owner PAUL B SMITH Create Date O6/26/2013
Contractor D.R. HANSEN PLBG. Category 410-Residential-Interior 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 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 FINWst Sink 0 Bidet 0 Site Drain 0 Misc. 0
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 _ 0 Drink Ftn 0 Int Grease Trap 0
Fioor 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 MULTI FAMILY/Separate water �
of Work �
j � o41ot f ac�,�F �c
�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0904880000
Valuation $1,500.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By ��'V`, Date O6/26/2013
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 55 KNAPP ST OSHKOSH W� 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.
c�ty of osnkoan
Inspection Servic�Division �
POBox113U �
Oshkosh,WI $4903-I 130
Phone: (920)236-5050
F�:(920)23G-5084 O KO H
ON TI�IE WATF.R
Piumbing Permifi A,pplication
T hercby apply fpr a permit to do and install the following plumbing on Yhe premises herclnAfter described,thc work to conform W the
Wisconsin State Plumbin�Code,in the performance of which all parties hercCo agree to and arc bound by said statutcs.
� Application(s)and fee(s)can be brought to City Hall,Room 205 or mailcd to lnspection Services,Po-Box 1128,Oshkovh W T :
54903-U 28. Commencing work without permit(s)wil! result in foes k�einR doublcd or$100.00 plus the normal permic fee,which
cvcr+s greater. ,
� OR
/f y� are a conlracl� articipalin �,J,l,�e Permit F'e� _Ac�.ount SNs(em an_d_h�,ye adequale funds. check here
�f vou wan� thi,� proccssed lhrQUgh vour accoun� �
**Advisory-Fox a�p��icablc projects, sua P.lec�ical7nst�Uabio�verification(E��otm,signed by the Electx�ical
Coutractor or Homeowne�r(far installatioz�s attowcd to be perfox�med by tbc homeownear)�ouust bc snbmitted
with thc permitt tipp�cadon. A,pplitatxon.R snbmitted witt�ont an EIV whe�u sncb is re�ni�cd,wil]not be
zrroccsscd for Pe�t�ssaancc and w�.kbe xetarncd far co�ou.pletion.
3 '� � c.c� �� ��s v o .cl� , �6 r
Job .A,ddress .3 (6 Va�Ue(Including leborand rturtq'�o�s) Aate � �
(lwner �� 5�� Contractor 11 /'►'16 �..�.�
❑Si�agle Family �Aap�ea ❑Multi-Farnily ❑Rcntal Commercial ndastrial
Number of F�xtoxe,�: �
Bathtub , Sump Pump , Plasia Sink Itoof Urein
Showct Snn.Sump/Pump Scullcry Sink Sodn Diap
Whirlpuol Wala SoRCna' Strvicc$ink CofTcc Mkr „
Lavelory Standpipe Rct 5hnmp�ink ,�,�, 3itc nroin ,,, :
Toild Geragc PD Surp,Mr�v Cink Wnirrg$m _,., ,,�
Kit Sink Locst Wsatc 5terlNz�:t ICC Ch"W"l ,
• Diaposal Bnr Sink RP7 Vnlvc Comm Icc Mnkcr
U�sh��nel�er �rcnkrm Sink t3idet lnt Grcnac'frap
Floor UrA�n Clussrm Sink Urinsl Ext Grcaac 1'rap
I•lose Bibb GXem Sink Bear Tap Eyc Waah Stn
Wot�}�p���. f Prop 3ink Dipper Wcll Deduc►MClcr
I.J Cr,�s f:l Elcct f,l PwrVnt Flnor Sink brink FnLn W[r SewCr Mcf
clom�wahr ryAna Sink � . Wnsh Bntn •. Wi�Us.�utc Ma
Lndry Tray l�b Sink Gttth F3��gin , Miec Pixwre.a
Electric Contractor(for projects not requir�n� an EXV Form)
Use/Nature of Worl� ��2 rS(� UI�Y�-�1�
Sizc MaCeria) Type �/, Conn_Type °
Sanitary Sewer
Storm Sewcr
Water Servicc
o6ioy