HomeMy WebLinkAbout0156704-Plumbing (bathroom remodel) � CITY OF OSHKOSH No 156704
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 919 EVANS ST Owner DAVID/NANCY TOMASCHEFSKI Create Date 07/15/2013
Contractor REBATH OF CENTRAL WISCONSIN Category 410-Residential-Interior Plan
Inspector Jon Mueller
Bathtub 1 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
Whiripool 0 Sump Pump 0 F Prep Sink 0 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 1 San Sump/Pump 0 FINWst Sink 0 Bidet 0 Site Drein 0 Misc. p
Toilet 1 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. p 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/bathroom remodel
of Work
*'debit acct"
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1106610000
Valuation $650.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By �� Date 07/15/2013
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 230 N KOELLER ST OSHKOSH WI 54902 -4104 Telephone Number (920)765-0068
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.
�u1, 15. 2013� 2: 08PM REBATH CENTRAL WI 9203035935 . . No 4367► P 1/3
� usGlcosn, w154yu3=11jo �. � . \�/ .
Phone:�(920)236-5050 � � . � . . �. � �, . � .
�; Fax:(92p)�236,SO�. . . . �. � . � � . O.f HK .IH
' � • � . ON rMe wnrER
, , � . : Plumbing.Permit Application. � �
I hereby apply for a pezmit to.do and install the following plumbiqg on the premises hereinafter described,the work to conform to the
Wisconsin State Plumbing Code,in the pe�formance of which all parties hereto agree to and are bound by said statUtes.
•. Application(s)and fee(s)can be broug6t.to Caty Hall,Room 205 or mailed to Inspeciion Services,p0 Box 1128,Oshkosh Wl
54903-1128. Commencing work without permit(s)will result in fees being doubled or�1�0.00 plus the nonmal permit fee,which
ever is greater. �: �
OR
I u are a conttae[or artici atin fn !he Permit Fe� Account S stem and have ade uate unds chec.k here
f ou want this tocessed throu h our accoun[
**Advisory-For applicab�e projects, an Efectrical Installation Verificativm(EI�form,signed by che�leccri.cal
Contractor or�omeowner(fox installazions allowed to be perfoimed by t14e honneowx�er)mnst be submitted �
with rhe pe�xit a�plication. A�plications submitted vvithout an IIV when snch is rec�ui�red, will z�ot be
processed for Pernait Issnance and will bc retamed for completion. ��
Job Address q 1 a �v�.ns �a��t.°� V9II1C(Including lafror and mstorisls) S '� Aate �,��
Owner 3 �l U� Contractor �11�S�1n�201'1'1 .{� ilA�Q}�lDns � 11' �'.�{�I-} ;
�Single�'amily Obuplex QMulti-Family []�.tental ❑Commercial �Industrial ,
Number of Fixtures:
Bathmb � . Sump Pump Plaster Sink Roof Drain
Shower S�•Sump/i'ump Scullery Sink Sod,Disp
4Jhirlpool Wufc SoRcner Se,vice Sinic �o�iee ivilQ
Isvnlory � Stan�ripc Rcc . Shamp Sink Sile Dra�a
Ioilet G�agc FD . Sur�,eons Sink Waias Sm
Kit Sink I.ocal Waste SxriGur ' • Ice Chest
Disposal Bar Sink RPZ Valvc Cortun!ce Meka
pishwasher Breakrm Sink 'Bida � Urc Greasz Trap
Floor Urain Class�m Sink Urina! Ext Grease'frap
Hose Bibb : Gxarn Sink Beer Tap • Eye Wash Stn
Water Heat�r F�p Sink Dipper Well Deduct Metcr
❑Gas❑Elecc 0 PwrVn[ Ploor Sink Drink Fnm Wtr Sewer Mtr :
Clo�hc:s Wsh; ..Hand 1mk .
, ... . . Wosh Fntn ..... .. Wv U4age MV
.. ._..•—
---.—•---l�ndry_T.!vY_._._... Leb Sink. _.. Calr.6�asin.._........ ..-
. Misc
_...._... Fixturcs.
Electric.Coz�t��.etoz�(for projects not req�iring aia E�JFormi) �
.. _._. _:.._....__.... _.. _ _ . . . ... ... . . .. . ..... .:.. . ..
. .... . ............... . . . .
.... .. .
FJse��xtiire o#'Wvrk � ... .... . ... ._.... . ---.. .. .... ......
' ... ; � Size Material . Type # Conn Type
Sanitary Sewer • � , •
Storm Sewer ,
Water Service
. ... . ' . . 06/09