HomeMy WebLinkAbout0156652-Plumbing (laterals) � CITY OF OSHKOSH No 156652
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER .
Job Address 416 OTTER AVE Owner WELLS FARGO BANK NA Create Date 06/11/2013
Contractor M P KELLY _ Category 401 -Residential-Exterior(laterals) Plan
Inspector Jerry Fabisch
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 Breakrtn Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature SFR\Raze house/capping water and sewer laterals
of Work
Size Material Type # Conn.Type
Sanitary Sewer 6" Vitrified Clay Lateral 1 Aband
Storm Sewer
WaterService 1" Iron Lateral 1 Aband
Parcel Id#
0200440000
Valuation $300.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I
Issued By �� . Date 07/12/2013
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 wi hin an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and t secure an "ecessary approvals before starting such activity.
Signature ' ''� Date '7-/2 - /,3
AgenUOwner
Address 665 N MAIN ST OSHKOSH WI 54901 -4431 Telephone Number 231-1750
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.
� . P. KELLY, INC.
c�tyofoSnkosh 665 N. MAIN STREET
Inspection Services Division 0 S H K 0 S H, �/�S C. 5 4901 �
P O Box 1130 �
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084 O HK�H
ON THF WATFR �
Plumbing 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.
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI
54903-1128, Commencing work without pernut(s)will result in fees being doubled or$100.00 plus the normal pernut fee,which
ever is greater.
OR
I[vou are a contractor participating in the Permit Fee Account Svstem and have adeguate funds. check here
if vou want this processed through vour account n ,
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor ar Iiomeowner(for installadons allowed to be performed by the homeowner)must be submitted
with the permit application. Applications submitted without an EIV when such is required,will not be
processed for Permit Issuance and will be returned for compledon.
��� ��`
Job Address �IG OTr�� , Value(��iva�g iabor�ce�� ' �p�.
�l , �v
Owner V�l tractor
❑Single Family ❑Duplex ❑ ulti- amily p�K�7����� 5 dustrial
1
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San.Sump/Pump Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Coffee Mkr
Lavatory Standpipe Rec Shamp Sink Site Drein
Toilet Garage FD Surgeons Sink Waias Stn
Kit Sink Local Waste Sterilizer Ice Chest
Disposai Baz Sink RPZ Valve Comm Ice Maker
Dishwasher Breakrm Sink Bidet Int Grrease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Sm
Water Heater F Prep Sink Dipper Wetl Deduct Meter
❑Gas Cl Elect Cl PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
��Y T�Y Lab Sink Catch Basin Misc Fixtures
Electric Contractor(for projects qot requiring an EIV Form)
Use/Nature of Work�,/ J' (t� ��[,G{�.�.�
Size Material Type # Conn.Type
Sanitary Sewer (,,� �f � �a�
Storm Sewer
Water Service
06/09