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Home My WebLink About2013-Plumbing (water service repair) � CITY OF OSHKOSH No 156996 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1602 ROOSEVELT AVE Owner CYA PROPERTIES LLC Create Date 07/30/2013 Contractor MERTEN PLUMBING&HEATING INC Category 401 -Residential-Exterior(laterals) Plan Inspector Jerry Fabisch Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters Shower 0 Lndry Tray 0 Exam Sink � 0 Sterilizer 0 Soda Disp 0 Wtr Sewer Mtrs p Whirlpool 0 Sump Pump 0 F Prep Sink 0 RPZ Valve Lavatory 0 San Sum /Pum 0 Coffee Maker 0 Wtr Usage Mtrs p P p 0 FINV1/st Sink 0 Bidet 0 Site Drain Toilet 0 Water Softner 0 Misc. p 0 Hand Sink 0 Urinal 0 Wait.St. 0 Fixtures Kit Sink 0 Standp Rec 0 Lab Sink Dis osal — 0 Beer Tap 0 Ice Chest p P 0 Gar Drain 0 Plaster Sink 0 Di Well Dishwasher p 0 Comm Ice Maker p 0 Local Waste 0 Sculry Sink 0 Drink Ftn Floor Drain 0 Bar Sink 0 Int Grease Trap p 0 Serv Sink 0 Wash Ftn 0 Ext Grease Trap p Hose Bibb 0 Breakrm Sink 0 Sham Sink P 0 Catch Basin 0 Eye Wash Statn p Water Heater p - Use/Nature SFRental/water service lateral repair of Work 'ck#11996'* � � Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service 1" Copper Lateral 1 Repaii Parcel Id# Valuation $1,445.00 Plan A 1212530000 pproval $0.00 Permit Fees $50.00 ❑ Permit Voided j ' Issued By '�' Date 07/31/2013 In the pertormance of this work, I agree to perform all work pursuant to ruies 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 1087 COZY LN OSHKOSH WI 54901 - 1404 Telephone Number 231-6795 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. City of Oshkosh Inspection Services Division P O Box 113a � Oshkosh,WI 54903-1130 � Phone:(920)236-5050 Fax:(920)236-5084 OlHKO H Plumbing Permit Application ON THE WqTER I hereby apply for a permit to do and instail 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-I 128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which ever is greater. OR I ou are a contractor artici atin in the Permit Fee Account S stem and have ade uate unds check here t °u N'a_ nt this processed throzrgh vour account n **Advisory-For applicable projects, an Electrical Installation Verification Contractor or Homeowner(for installations allowed to be performed by the omeowner)must be s bmittedc� with the permit application. Applications snbmitted without an EIV when such is reqnired, will not be processed for Permit Issnance and will be retarned for completion. Job Address p � VaIUC(Including►abor and materials)�I�j�� Date 7" � Owner �_(,�C^�,q�� Contractor svl�,�., . PCs�-�tl� ❑Single Family ❑Dupleg ❑Multi-Famil Y ❑Rental ❑Commercial ❑Industrial Number of Fixtures: Bathtub Sump Pump Plaster Sink RoofDrain Shower San.Sump/Pump Scullery Sink Soda Disp Whirlpool Water Softener Service Sink Coffee Mkr Lavatory Standpipe Rec Toilet Shamp Sink Site Drain Garage FD Surgeons Sink Kit Sink Local Waste Waitrs Stn Disposal Sterilizer Ice Chest Bar Sink RPZ Valve Dishwasher Breakrm Sink Comm Ice Maker Bidet Int Grease Trap Floor Drain Classrm Sink Urinal Hose Bibb Exam Sink Ext Grease Trap Beer Tap Eye Wash Stn Water Heater F Prep Sink Dipper Well �Gas L Elect G PwrVnt Floor Sink Deduct Meter Clothes Wshr Drink Fntn Wtr Sewer Mtr Hand Sink Wash Fntn Lndry Tray L,ab Sink Wtr Usage Mtr Catch Basin Misc Fixtures 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