HomeMy WebLinkAbout0156883-Plumbing (outside faucet) � CITY OF OSHKOSH No 156883
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1610 W 5TH AVE Owner DAVID J WRIGHT Create Date 07/25/2013
Contractor D R GLAZE PLUMBING Category 413-Res-Interior(Replacement Fixtures) Pian
Inspector Jon Mueller '
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 RP2 Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 FINWst 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 1 Breakrm Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature SFR/replace outside faucet
of Work
"ck#1229**
�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0611410000
Valuation $175.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By _��"� Date 07/25/2013
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 1865 JAMES RD OSHKOSH WI 54904 -6873 Telephone Number 920-589-4014
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 specifed 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.
Crty of Oshkosh � ��
Inspection Services Divisio¢ �
P O Box 1130 � �
Os6kosh,WI 34903-I130 �
Phone:(920)236-SO50
Faz:(920)236-5084 ��y�///���� J)�7
:lN HL F WA1FR �
Plumbing Permit Application
I hereby epply Frn a pecmit ro do md'mstell the folbwmg plumbmg on ihe premises heceinafter described,the work ro confmm to the '
W isconsm 3tate Plumbing Code,m fhe perfmm�ce of ahich all paities hereto agree to and am bound by said statutes -
• AppGcaboe(s)and fee(s)rm be brougLt to Ciry Hall,Room 203 m mailed to Inspection Services,PO Box 1128,Osh]cos6 W I �
54903-1128.Commencmg wodc wRh�t peimil(s)will resuk in fees bemg doubled or S I00.00 plus the nomal petm it fee,which
ever is grea0er. �
OR
{�,you a.e a contracror nartic(pating in the Permit Fee Accornt System and have adequate junds check here ��
ijyou u�ant lhis nroressed througA vour account n
�Y Advisoty-For applicable p�ojecls,an Electrical 7nstallarion Veri6cation(EI�focm,signed by the Electxical ���Q
Coutracta or Hameow�r(for iastallations allowed w be petformed by the hameowue�must be submitted � �
wrth the petmit apQlicatiaa AQpflcatioas submitted without an EIV wheu such is re�rimd,wiII not be
processad for Petmit Issuaoce and wi((be retumed for ca�pletiaa. p
,T� � �
JobAddress ��D W �v1�k. Valoe��do��mamam�:> �J Date��� �
ow.� �4V(D d�Ciu� (d1Z16t(T' cooc�ao� �1z�t�C �B�G �����
�y}'single Family �Dapki �Muttl-Famllv ❑Reotal ❑Commercial ❑Indastrial
'.Qomber of�tares:
Bahtab SmPPamD PlastaSak __ RodDrsa __ _
Shwa _ Sm.SueP��P —. Swllc9 Snk __.__ . So�DieP _____
pm� _ WyQSdtmc _ SeniceSiek C�ee!� _ .
L�vYQ3' _ 5�^dPP�R« ShmpSink _ Sitelkan .
Tde .___-- Ga�`FD _.__._.. 5ur6eaes5ok ______. Wain9m ..._. �
KaSok LadWssF Stm7i:e _.__— keCLest -._.
_--
p�+� __.___ BrSiok ___.___ RPZV.ive _.___._ Cammke�faka ___._. �
Dishwa�v Hreatrm Sink Bidet _ Ivt Cueau T(ap .
floarDrsia .._..- QesamSink _ (:rind EatCnuxTrep ..
Hose B3b � Exa 5ok _._.___. Bea Ty .... EYe Wash Sm _ .
RLe H yer F�D�' APaa Wdl Ded�c[Nde �
Gs Elac Pw�rVat Floar Smk .____.. Dmk Fam ___—_ Wtr Sewc Mtr ._.__ �.
CMi6es W� _.,._.. Il�d Smk Wffi Fom _ Wtr Usage Mtr ..
L�7T�+5' LabSmt _ CarABdn _ �SscFrstum _ �.
Electric Contrador(for projects not requiring an EIV Form)
Use/Natnm ot R'ork �P'L,Q)� FEY�(G b.�
Size M�erial Type # Coun.Type
Sauitacy Sewrr �
Stam Sewer �
W arer Service '�.
O6/09