HomeMy WebLinkAbout0157323-Plumbing (kitchen sink & dishwasher) � CITY OF OSHKOSH No 157323
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1535 SANDERS ST Owner LOREN R DIECK Create Date 08/20/2013 ,
Contractor HOMEOWNER Category 410-Residential-Interior Plan
Inspector
Bathtub 0 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
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 Fir/Wst Sink 0 Bidet 0 Site Drein 0 Misc. 0
Toilet 0 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 1 Local Waste 0 Sculry Sink 0 Drink Ftn 0 Int GreaseTrap 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/install new sink and dishwasher
of Work
'*ck#1140*'
Size Materiai Type # Conn.Type
Storm Water
Parcel Id#
1305060000
Valuation $500.00 Plan Approval $0.00 Pertnit Fees $30.00 ❑ Permit Voided I
Issued By � Date 08/20/2013
�
The undersigned,in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the
principle residence of the undersigned,hereby acknowledges,per Wisconsin State Statutes,ss 145.06,that other individuals
will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing
the work involved must be covered by a permit issued to a properiv licensed Master Plumber.
In the performance of this work, I agr rform all work pursuant to rules governing the described construction.
Signatur _ Date ��(�
AgenUOwner
Address 1535 SANDERS ST OSHKOSH WI 54902 6361 Telephone Number
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Pertnit 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.
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.
City of Oshkosh
Inspection Services Division �
P O Box 1130 �
Oshkosh,WI 54903-1130
Phone:(920)236-5050
F�:(920)236-5084 O1HKO.IH
ON THE WATER
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 Nall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI
54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which
ever is greater.
OR
1f vou are a contractor narticipatin� in the Permit Fee Account Svstem and have adequate funds check here �
i�'vou N�ant this nrocessed throuQh vour account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be snbmitted
with the permit application. Applications snbmitted without an EIV when such is required, will not be
processed for Permit Issnance and will be returned for completion.
Job Address L J.��� �Gi/f�e/'.f �fi VaIUe (Including labor and materials) � Date L V/��
Owner �C91`P� D�ec:k Contractor
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San.Sump/Pump Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Coflee Mkr
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitrs Stn
Kit Sink � Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher � Breakrm Sink Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Stn
Water Heater F Prep Sink Dipper Well � Deduct Meter
C Gas 0 Elect C PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fi�ctures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09