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Home My WebLink About0157565-Plumbing (new floor drain) � CITY OF OSHKOSH No 157565 OSHKOSH PLUMBING PERMIT -APPUCATION AND RECORD ON THE WATER Job Address 3346 HARBOR BAY RD Owner MATHEW T/JANE R RICHARDSON Create Date 09/05/2013 Contractor REBATH OF CENTRAL WISCONSIN Category 412-Res-Interior(New/Relocated Fixtures) Plan Inspector Jon Mueller 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 Whirlpool 0 Sump Pump 0 F Prep Sink 0 RP2 Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0 Lavatory 0 San Sump/Pump 0 FldWst Sink 0 Bidet 0 Site Drain 0 Misc. p Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. � 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 1 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 floor drain of Work "debit acct'" i Size Materiai Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# 1550350000 Valuation $400.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided! Issued By 7� Date 09/05/2013 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. ' Sep 5 2013 . 9.57AM REBATH CENTRAL WI 9203035935 . � � . No. 4511i�• P. 4/51� �. � . � • : .. .' .•.. . '.. . . •. ,. ' . ' ; '• � ..�.; .'' :� '... ON TME WATER� .. . . • . .. .: .� . Plur�biny Perr��a{�p �ca .io�..� �� .. . .. . . . . . ... : ... � . . . . .. Y hereby,apply,for.a permit to do and.ivastall rhe•following plumbing,oq the premises hereinafter describcd,the work to conform to thc� � �. . �Wisconsin State Plumbing Code,i�n,the pes�'ormance�of whicb,,all psrties hereto agee to and are bour�d by said statutes. ' •: Application(s)and fee(s)can be brought.to,City.I3all,Room 205 or mailed to Inspecuon Seryices,p0 Box 11?8,Oshk'os6 Wl . 54903-11?8: Co�nmencing work wirhout permit(s)wil1 result in fees being doubled or�100.00 plus rhe normal:permit fec,which • .. ever is gieater. � . . � : . ; OR � , . � I u are a conttacfor artfc� atfna rn [he Pe�mit Fee Accounl S�.sten: and have ade uate unds check here �i ou N�ani t.his roces.red thrDu h vour occounl � . ; **,E�.dvisoay-For applicabie grojeets, an Elec�ical IustaLtatnon Verif catiQZi(ETVj�ozzzz, sig�ed by the Electnie�I CQniractor ar�iouaeowner(fnz z�staIl�tions allowed to l�e performed bp the homeowner)�vst be s¢bn�tted ' �viCh the pe�it ap��ZCa[ian. A��plications s�bmi[ted without an EIV whe.B sucli is required; �vi11 not be piocesscd for Pern�zt Fssuance aud w�e'll be rctu�sned for�O pletion. �� Job Address��=� ��r � l . p-p C} � r'Vaiue(t�ci�am�i�or�a��R,��) � Date Owner �Ql.�}'� I�.�C�1c�dSQ1'1 Contractor i'M�S�-t`n o�Q.S.S�Ii.�I1 bY1S ,��} �" ` � ❑Siu�le Family �Duplea QiV�rtlti-Fabaxly QRental ❑Commercial �Fndustrial Number of Fi�etures: Bathiub Sump Pwup Plas[ec Sink . Roof Drain � SLowcr San.Sump/purnp Scullcry Sink 5oda Dicp . �nQipooi W"uer Sofczner Scrvice 5ink Coi�ee lvikr Lsvatory Seandpipe ttec Sharnp 5idc Site Dr�in Toilci C}ar��e FA • S�ugcoris Sink. Waitrs SEn I:it Sink Locai DVasic . Sterilizer • !ce Chest . Disposal �Smk RPZ Valve Cornm lce Mbker Dis6dashcr $�alQm Sink' . �.Bidet . Int Grcase Trep• . F7oor Drain � . Classrm Siak . Urinsl F�Grcase Trap . . Hose Bibb Exam Sink 19eer TaP Eye vVach Stn � Watcr Hcsw • F Ptep Smk � DiDper Well Deduct Mcter _ .:;�Qes 0 Elea o.PwrV� . Floor Sink Drink Fnpt � �y _ ..:• . � Cloches Wsbr ` -.. tr . . HandSink_. . . ....._._.:._._W�h�nfi._...._.__.._..... WQUsave M� ._...._La�'-�raX..:.: � ..Lab.Siak .. . .. ........ . . . . . .. __ _ .•-•••...__. . . .. ..CatchBasia._.__.—::.._., . .. Misc.Ei�a.cs.._.... .. . .. . .. . . • . . ....... . ... .. �lectrie.Coniractor(for grojects��a�t req�irFng an�Y'V]Form) � . . ... . . .� . ... _ _.. ... . . . .. . .. _...------ -----�--..._.. . . ... . . ... . ... ._. ...__.._... . . ... .. .... . . YJse l Na�ure of`Work � .. . :.:. � .. ...._._._._._..._ ..... _.._. . - �---�- ..... . .. � ^ . . .. . Size ' Material. Type' ... ' �:.. . Conn.TVpe : . Sanitary Sewer � . ' ' Storm Sewer. : . • . • . .: - . ' Water Service. : . .. . � . . . o . . � . . .... . . . ' . . „ . . . � � . � . . � . . . .. . :. .