HomeMy WebLinkAbout0156523-Plumbing � CITY OF OSHKOSH No 156523
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1130 N WESTFIELD ST Owner EVERGREEN MANOR INC Create Date O6/19/2013
Contractor JIM'S PLUMBING 8 HEATING INC Category 442-Commercial-Interior(New/Relocated Fixt� Plan
Inspector Jon Mueller
Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 22 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 4 San Sump/Pump 0 FIr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 4 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 Well 0 Comm Ice Maker 0
Dishwasher 0 Local Waste 0 Sculry Sink 0 Drink Ftn 0 Int Grease Trap 0 :
Floor Drein 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 COMM/Evergreen Retirement Community/The addition of two resident rooms and general interior remodeling of
of Work Creekview South households 5 and 6. "check#388690
i
i
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1608640000
Valuation $36,000.00 Plan Approval $0.00 Permit Fees $270.00 ❑ Permit Voided I
Issued By� Date 07/03/2013
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the Ciry 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 W6166 GREENVILLE DR GREENVILLE WI 54942 -9676 Telephone Number 920-757-5258
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.
07/03/2013 07:13 FA% 920 757 6482 JIM'S PLUMBING C�002/002
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Plumbing Permi� qppl�catiort ON THF W/1TFR
1 l;e.reL.� apF�l�, for 8 ��i'illl[t0 CIU 81i:� i��si�tll the followin�p).umUing:n:::;�e premises hereinafrer describeci,the��•ork to conform to ihe
�� i,c�+n�in Scate Flumbir,g Code, ir� :i�e.perFormance ot �;���i�.h �1° paiiies heret.a a�ree to and ar�bound by said statutes.
° .�r�� �1'ion(si�ind fce(s)can be?�ro;;,�'.�t �o Crty Hali, Roum =ii^ �;,;;;�Ziied to Inspection Service;, t'O i3ox 1 128,Oslikosh ��J
��+`.�'t� i;2�. CO1Y1111211Cll1�1F'OCk �.�it�;oat }?ermit(s)��;ill result in ;�:�s L?clll�dOl1I)JCC� 01'�]OO.OU�tIUS f}1@ 1]01'iTic�I(JetTttlf �Ce,which
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s�leni a���! hcrv� ;1-�.�q��ate fundc check h��c
�i.r�u :�ctitl !hi,s' l�roce,��sec( thrr�rt j. ti�nrt�• accou�^l
�*Advisor��- For appliea�le pxoJects, an�iect���cal I��stallutzoi�Verifrcatiox�(EI�'} forzn, signed by die Eleetrical
Contractor or Homeowner(for instaltatior�s alfowcd to be �erfoi-�ned by tlie honieowner) tnust be submitted
with tlte perinit ap��lication. Applicatio�as siiF�initted �vitl��ut aFi EIV wlicii sitch is rcquired, will not I�e
processecl for PernAit Issua,r�ce and will be reh�rne,i for coingletior�.
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ti�c .... G�=' S�n �.,;'F: ,;i —�. .;',icrv tiink
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. ��'ater S:.-_ _; _._ _..�:e Sii�k
� — � Cof'fee Ivtkr
L::�;,t• . Standp:i:.:�.�:. �; ,,nr�ii�k
� --- "' �. Site Drain
"i';;iict (;ara(tc Fl:a
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=.:it tiir;k 1_ocn!'„�i�te �;�.
t �iiter Ice Chest
`_'�i.:r.as,: Ciar.Si,�;; _, i'-�'�Va!ve Comm Ice�Qakcr
i?i,;(t',�a<:he; Brca;:;;:��:;;;k ..,.,_. 1ntGreascTrap
`'" _ C1,i�.�r;r,�;;;� __.___. - ...,�� Gxt Urease Trap
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i ic�se!�;:�;+ ---- f_x�n,jii�k _ ._.,r 7::P _ Evc�'�'uh Sui
'`.1.!G'Ffc;iter F'PfCr�ink z�';uner;Vell
� , Deduct Meter
'c.;a;:_..�....."?YGVr\'nt Pluor�;��n _ �.in�i�r,tn Wtr Sewcr 1�dlr
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_ `,y a�:�i ntn Wtr Usagc hftr
I.ni�ry't::, _. La!>>inx ,aiutC3a�in
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L' IE;Cft'it' COIItCAI'��Y (tOI' j)Y(3�e.CfS 120� 1"fE�l1II'lll� ar2 rIV FF)i'tYi}
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