HomeMy WebLinkAbout0157505-Plumbing (shower) � CITY OF OSHKOSH No 157505
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1615 MOUNT VERNON ST Owner ARVID M/ANTONELLA F CARRICK LIFE ESTAT Create Date 08/28/2013
Contractor REBATH OF CENTRAL WISCONSIN Category 412-Res-Interior(New/Relocated Fixtures) Plan
Inspector Jon Mueller
Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 1 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
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/new acryic shower to replace cast iron tub �
of Work
II"debit acct"
I
�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1504740000
Valuation $500.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I,
Issued By �� Date 08/30/2013
v
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;40A�� . REBATH CENTRAL WI 9203035935 �. . No. 4491�P�1/4 .:
.,..,,. �....,���.,-.,,,��
, Faz:(920)236-5084 . . � . .
� � . . � QlI�IKO H �
. . ON THE WATER
� . Plumbing Permit Application ` �
� I hereby apply for a permit to do and install thc following plumbing on the premises hereinaf}er described,the work to conform to the
' 'UViseonsin State Plumbing Code,in the performance of which all parties hereto�agree to aad are bound by said stamtes,
•: Applieation(s)an.d.fee(s)can be brought to City Ha11,Room 205 or mailed to Inspeetion Services,PO Box 1128,Oshkosl�WI
5A903-1128. Coramencing work withautpertnit(s)willresult in fees being doubled or$1pp.00 plus the normal permit fee,whicb
. ever is greater. � �
OR � .
I ou are o contractor artici atin in the Permit Fee Aecoun� S .rtem and have ade uate u,�ds check here
i ou ►,�An[ this rocessed rhrou 1� ur accounr
**Advisory-For a�plieable projects, an Elec�ical TnstaIlarion Verif catYOn(EI'V)fozm, sig�,ed by the Elertricai
Coritractor or Homeowner(for installatxvns allowed to be perfo�ed by the homeowz�er)mnst be�submitted �
with the permit application. Applications sabmitted withont ari EIV w�ie�such is re�unrcd, will not be
processed for Pezmit Issuance,a,n,d vvill Ue returned for compledon.
Job Addr ss l� � S J1/��, C�- ����� � /� ,�y-� g �� f�
��nOn'-�I VaILe(Including labor and meccrials) ��V• �1 v bate
O mcr � � � 1 Contractor �S�'1/��h0)MQ�S �'l�
�ingle Family �DuQiex �Mu�ti-Famity []Rentat
❑Commerciai ��dbstrisil � ,
Number of Fixtures:
BathNb Smr►p Pump Plac[er Sink �
.� Roof Drain
Showcr San.Sump/P�nnp Scullery Siak Soda Disp
W'niripooi 14ater SoRener Scrvice 5iuk .
Cor�cc irifc,�
�.avaoory StaudP�� Shamp Sink Site Draia
Toilct Gbrago FD . - 3urgeons S;nk Waivs Stn
Kit Sink Local Wasie
Steriliaer Ccc Che,t
Disposal $ar Sink RPZ Valve Comm Ice Msker
Dishwsshcr ' Breakrm Sink -Bidet Int Grea�e Trap �
kloor Drain C7assnn Smk. Urinal Ex[Gressc Trap
Hose Bibb Ewzm Sink Beer Tap . � Eye Wagh Stn �
waner Hcater F Prep Sink , biyper Well „ Deduct Meter
•d Gas�Elect 0 PwrVnt Floor Sink brink Fnm Wu Sewer Mtr �`
Clothcs Wshr Hand Smk --.. -• W�Fpm . .. ..._. WU C1s e M
...._.. .
•.--. �....U.
--....._.l.o.d.ry_Tray . ... Lab.Sink-. . .. . .. .. CacchBasin .. --.�.. Msc�irmues .. _ . _
.. ......
Electric Contractor�(for projecis not requiring an EzV For�) � �
.. _..._--... .. . . .... ....
. . _.�.. .. . .. _. _......
--.__... . . . .. ... ._.... ...
. ..
Use��]�T�atare of Work . .. .. . .._...__....... . . .
S�. Material .. Type # Conn.Type
Sanitaiy Sewer ' �
Storm Sewez
Water Service. .
06/09