HomeMy WebLinkAbout0157507-Plumbing (bathtub) /�"� CITY OF OSHKOSH No 157507
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER ;
Job Address 1215 LOCUST ST Owner DONALD W/BONNIE M BORGEN Create Date 08/28/2013
Contractor REBATH OF CENTRAL WISCONSIN _ Category 413-Res-Interior(Replacement Fixtures) 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
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. 0
Toilet 0 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
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 �SF nstall acrylic bathtub
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of Work �
'*"debit acct'*
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Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1612530000
Valuation $400. 0 Plan Approval _$0.00 Permit Fees $30.00 ❑ Permit Voided ',
Issued By Date 08/30/2013
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.
Aug, 28, 2013 10:41AM . REBATH CENTRAL WI 9203035935 �. No. 4491� �• P, 3/4 i .i ° � E
.
. � . . . �
• . ON i„t wn�ER .
. . . � : . . . P�u�bir�g Pe��r� /-��R[��afior� . :
Y hereby apply:for a permit to.do and install thefollowina plumbing on chc premises hcr.einaf�er descnbed;the work to�conform to the�
. Wiscozisin Sta#e plumbnng Code,in.the pei;f�rmance of which all parties hereto agree to and are bound by said statvtes.
� •: Application(s)and fee(s)can be broughtxo City.Hall,Room 205 or mailed to InspecEion Services,PO Box 1128, Oshkosh WI .
54903-1128. Corn.mencing work without permit(s)willresuJt vn fees being doubled oi$100.00 plus the nvrma!permit.fee,whlch
. ever is greater. � �.
: OR . . � . :
I � u are a c nlraczor art�ct a.tin 1n the ermi� x'ee Account S stem and have ad� uQCe unds chec.k here
if vou wanl thi c rocessed throueh t�our accaunJ n
**A,dvxso�y-.�ar appIieable projeets; aa�Iecaxcal F�2sta11atiQts VeriScatzan(EI'��'or� si
CQntractoz or:l�omeowner(for�sta�ations aTlawed to be perfozmed by tI�e homeowner)mc:setbe���edcal
�iCh the pezx�it a�plicat�on. Applica�iozxs sabmitted wrthout an EFV w�aen such is rec�ze�, wiF�not bc
processed far Perm�it Issuaace ar�d wi11 be zetumed�oz.co�ple�on. .
•Jo b Adtixess �1 Z�� L,O CU 5t" •�� Value(1nc�ud���Bnor ana mai�;�ts) O U-� Date $ �
� �
Owner �OIJ �D 1Z-���( Contracfor �US�1(1�10f 1�ZS Sbl.i;l, D�(1 S D,�'
. �
(�Sin��e Family �puplex O1VZulti_1+amf(y []�t�vta� �Cotc�mercial
dlntiiistrial ,
Number of�ixtures:
Ba�tub � � Sump Pump Plaster Sink� .
Roof Draiq
5hower Saa S�ur�p/Pun�p Scullery Smlc
Soda Disp
�naipool Warer Soz�wer .
l,avatory Service Sink . Cof�ce�ikr
S�ndp�e Rcc Shamp Sink Site Dtsin
Toilct �g�� .
Surgeoas Sink. Waius Stn
Kit Sink . Lomi Waste .
Steril'n.er � ice Chcsc
-Disposa! B�Smk RPZ valvc •
. • Comni Ice Make�
. DistnWashcr ' . ' ' Brcaf�m Sink 'Bidct .. • Xnt Grease Tra�
Floor�raia Classrm S�lc. ; Urinal . E�a Grcase Trsp �
....
Hosc.S►bb • Ezam Smk Bccr Tap. . ' Eye Wash Sm
Waicr Hea[er P Prep Sink . �
. bipper Well Deduct Meter .
•❑Gas 0 Elect 0 PwrVnt' . Floor Sink .
• . • .. Drink Fn�n � Wtr Sewer Mt�
_ Clothcs Wsl�t � Hand.�mk..:
. . , ,
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.. �itSh FAln._...... ._,..
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---- —L�i!!.Y-�rxy,_._ , ....'.. . ._..l.ab.5ink---....... . .... .CatchBasu� . .... -- --•-.
VVtr Clsage M�r
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--•- --..M�saF.i�aures. ...._
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E1�ectric Coa�ra��ar�(�or proj�ets�aot requxri�g an��?�'or�)� . . .. _ � . .
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�se7�ature oi'�York.,. .. - . . . .. . .. . ..-- -:---� �.:: . ....._ .
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5ize � 1�
aterial . : � e . .
. . .. �'P . � Conn.TyF,e.__ :
Satilt3l'y Sewer ' � : .
Storm Sewer . . . � . .
'<:GVater Service . .
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_. . . .. . . 06/05