HomeMy WebLinkAbout0156737-Plumbing (interior) �
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� CITY OF OSHKOSH No �ss�37 �
;
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ;
ON THE WATER
Job Address 206-212 ALGOMA BLVD Owner CHRISTINE ANN DOMESTIC ABUSE SERVICE:Create Date 07/17/2013
Contractor D.R.HANSEN PLBG. Category 442-Commercial-Interior(New/Relocated Fixt� Pian �
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 '_'
WhiMpool 0 Sump Pump _ 0 F Prep Sink 0 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0 �
Lavatory 2 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. p
Toilet 2 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. 0 Fixtures
Kit Sink 1 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 2 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 ;COMM/interior plumbing associated with the remodel of Christine Ann Center �
of Work
r
Size Material Type # Conn.Type
Sanitary Sewer
€
Storm Sewer
Water Service
Parcel Id#
0701280000
Valuation $8,000.00 Plan Approval $0.00 Permit Fees $63.00 ❑ Permit Voided '
Issued By ��.� Date 07/17/2013
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 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.
�
t
Cily of Oshkosh ;
Inspcction Serviccs Division '
P O Box I 130 �
Ushkash,Wi 54903-1J30 � ;
Phonc:(920)236-5050
r�x:(920)236-5084 � � Q H k
Plumbing Perm�t /�pplic�tion ��N TME WnT6k
T hereby apply for a permit W do and insrall thc foltowing plumbing or+ ehe premises hereinafter descri�d,thc wprk to conform to the
W��consin Scate Plumbing Code,in the performance of which all pertics hereto agrce to�nd arc bound by said ste�utcs.
� Applieation(s)and fce(s)can be brought to City Hall,Room 205 or mailed to Tnspection Services,PO•Box 1 a28,Oshkosh W1
54903-1128. Commencing work without permit(F)wil!result in fees bcing doublcd or$100.00 plus thc normAl permit fee,which
ever is gtcatcr. ,
� OR
1 ' u are a oafract r urtici tin in t Per it ee Acc �
c1t.r1 Svs1e»� pnd have adeg ple un�1s, check here ;
�ou wa�t lhis prRcesse t ti h r dccoun[
**Adviso�ry-For ap�lical�le�rojeet�, an Eleetricaa�iastallatxo�u ycri�c�oa(E�form,signed by the Electrieai '
Contractor rnr$omcoypmex�for i�tallati�s allowcd to be pe�rntmed by the ho�xeowneir)mnst be submitted �
wrth thc�noait a.pplieation. Applicat�ions snbaouitted withuut an E�V whdx such ic xeqnired, will not be 5
processed�o�parmit Zssaance a�nd w�1•be�etnrt�ed for com.pletion. a ,
Joh,A,ddre,gs�.b 6 �4�S/j Ih S � �� VAIUe(lncludinq Inborand mnlmnls) 0 U b ��w 7 1� � 3
� �� ^ Aate ;
Owner C�r1�3�A.0 �lh►'1 Contt'�ctor n P v,�d � �
❑Single Family �Duple� [].1►�ulti-Famil
y QRcntal Commercial ❑ dustrial
Nuttuber of k'ixtures;
B��'«' • Sump Pump PlFlsler Sink
Roof D�ni��
Showcr $nn,Sump/Pump _ Scullcry Sink
Sode pisp
Whirlprx�l Wa�cr$oftencr Scrvicc$iqk
CoR"re Mkr
Lavatory � Sundpip�R� ,� Shamp Sink
Toile� �_ �NrnRC� Sicc Dnin
$urR�pns Sink Wnitrs Sni
Kit 9in4: _�__„y I.oCAI Wa.stc 5tcrtllzcr �
fcc Chaa '
Disposol Bar Sink � . �
^� RP�Vnlve Comm Icc Mnkcr ;
n�sM�ncr e`� Rrealcrm Sink Bicld Int Gruiu Trap ^`
FloorDr.�in Clenarm$jnk Urinel P,x1 Grcese Tr,tp � �
Huvc BibFi Cxam 3ink BcerTnp F,yc Waah Stn ^'� �
Watcr Heata �Prcx�$ink bipper Wcll 1?ecluG Mcter �
I'I G�s CI�Icct CI PwrVnt floor 3ink �
Drink Ft1ln Wfr Scwer MU
Clothae W;F�r Fiand 3ink • '
l.nd T • �✓asl+Enbn •, Wtr Usap.e Mv
�' �' Lab Sink Catch BaRin .
Mirac Fixturen
Electric Cuntractor(for projects not requir�in�ar� EYV Form)
Use/�lature o�Work •
S�� Matcrial 7�,p� � _
. � Conn_Typc
Sanitary Sewer
Storm Sewer
Watcr Service
ti6/09