HomeMy WebLinkAbout0156378-Plumbing (laterals) � CITY OF OSHKOSH No 156378
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 156 W 19TH AVE Owner GENEVIEVE J HUGO LIFE ESTATE Create Date 06/26/2013
Contractor D.R. HANSEN PLBG. Category 401 -Residential-Exterior(Iaterais) Plan
Inspector Jon Mueller
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
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. 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 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 �SFR/New 1"water service
of Work
'*'debit acct"*
�
� :
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service 1" Plastic Lateral 1 New
Parcel Id#
1401840000
Valuation $2,000.00 Plan Approval $0.00 Permit Fees $50.00 ❑ Permit Voided I
Issued By 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
Agent/Owner
Address 55 KNAPP ST OSHKOSH WI 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.ity of O�hkosh
Inspcction Services Division �
P 0 Box I 130 �
Oshkosh,WI 54903-1130
(�hpne:(920)236-SO50
Pax: (920)236-5084 O KO H
UN IhIG WATER
Plumbing Permit �pplicat�on
1 hcreby apply for a ptrmit to do and install Ui�foilowing plumbing on the premises heroinafter dCSCribed,the work to conform to thc
Wisconsin State Plumbing Cod�,in thc performancc of wh'teh all partics hcreto agree to snd arc bound by said statutcs,
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mfliled to lnspcction Services,PO-Sox 112A,Oshkosh Wl
54903-1128. Commencing work withaut permit(s)will re.gult in fees beinE doublcd or�100.00 plus the normal permit fee,which
ever is�;rcater, �
� OR
!t vou are a conlrat!_o_P narticipalin ,,,Rn !he Perirril �ee �lccount v_sten� and hove p e uate funds. c_{t�ck here
i ou w [ this roce s thr v h accounl
**Advisory-Fo.r applicable pz�ojects, aa Elecbrical Installativa Vcrificatio�a(��form,signed b�ffic EIectrical
Con�tractor or Homeowmex(for instaUations allowed to be performed by thc homeown�eir)nan.ct be so,bmuitted
wxtb the penanit npplication. Applications sabbu�ittcd withomt au E�V when sacb�is x'eqnircd, w�11 not be
processed�ot'Pe:mit Issuancc aad w�kbe rctnrned frn'complction. .
'' 1 �� � DU . �v � � l
Job Addres,a 1 S,� �V � I VSIU�()ncluding laborand mnlerinls)� � Date �
Uwner � U � U Contractor � � V� �� L-�
❑Siugfe.Family QAuplex Ma1ti-Fart►i�y �Renta� ❑Commercial ndastrial
Nutt�ber of Fixttu'es: �
gethl,ub , Sump Pump Plasler Sink Roof i7rain _
Showcr Snn.Sump/Pump SCUllcry 5ink 5ada Uisp �„ :
Vlrhirlpool Water Softcna Qervico Sink CoffCe Mkr
Lnv�lory Stsndpipc Kcc Shamp Sink Sitc Dn�n �,,,
TOilc� _, Geragc fD Surgcaru Sink Wnitrs Stn
Kit Sink L.ocul W�stc 5tailizer ItC Chesc
. D'ISposal Bnr Sink RP7,Valvc Comm tcc Mekcr
�y.��h� Breskrtn Sink Ridet __,,,_„ Tnt C�'caac Trap _,�,,,,,
Flow Drain Classrm Sink Urinal �xt Grcese Trap :
HoRC BibA Exnm Sink Rcer Tap 8yc Waah Sln
Weta Heata �Prtp Sink ,� Dipper Woll Dcducl Malcr
I.J Cn,a I:I Elcct❑PwrVnt F��$ink Drink fnln Wtr SCwd'Mtr
Clothcs Wshr Hand Sink . Wath&nNt ', Wlr UsaRc Mtr
Lndry 7nY ��b Sink Catch Bnain Misc Fixtures _,,,,,,,�,�
Electric Contractor(for projects not requirin�an EIV Fo�)
Use/Natu re of Work _ � �W ( �/ W��,(,l ��'U�4Q
e
Size Material Typc {�, _ Conn. Type -
Sanitary Scwcr
Storm Sewer
Water Service
06/09