HomeMy WebLinkAbout0157602-Plumibng (laterals) � CITY OF OSHKOSH No 157602
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1504 ONTARIO ST Owner ROBERT H FENRICH Create Date 09/09/2013
Contractor D.R.HANSEN PLBG. Category 401 -Residential-Exterior(laterals) Plan
Inspector Jon Mueller
Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drein 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. p
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
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 Install 4"sewer and 1"water laterals �
of Work
"debit acct�'
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 New
Storm Sewer
Water Service 1" Plastic Lateral 1 New
Parcel Id#
1210270000
Valuation $10,000.00 Plan Approval $0.00 Permit Fees $100.00 ❑ Permit Voided i
Issued By ,"'�,� Date 09/09/2013
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 55 KNAPP ST OSHKOSH WI 54902 -3448 Telephone Number 233-1595
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.
Ciry ofOShkosh �
iacpcction Scrvices Division
P O Eox 1130 �
oshkosh,w[Sa9o3-1 130
Phane:(9z0)236-5050 O I u
F�c:(920)236-5084 � �
oN n�+�wnrER
Plumbing Permit l�pplication
I hcreby apply for a permit to do and ir�tall the following plwmbing on d�e prami�es horeireaRer described,thc worlc to wnform to tho
Wisconsin 3tatc Plombin�Code,in the perfnrmanee of which atl paKie�hcroto agree to and are bound by said s�wtcs.
• Application(F)and f+ee(s)can be broaght to City Hall,Room 205 or mailed to Inspection Servicas,PO Box 1128,Oshlmsh WT
54903-1128. Commer�ing work withaut petmit(s)wi��resulc in fecs being doubled or�100.00 plus the normal permit fcq which
cver is greater.
f vov re a_� ntOra lq,L arti inat,n in the�ermit Fee Accnun! Susleni and havg adeg���funds check here_
�_ —l�� G-
tJ1+o�„wan! lhis nr���c;ced hrouFh voar a�counl rI
**Advi�ory-Far appl3cable pxojccts,an Elecboical�st�IIation VcriStc�t'ion.(EI�foxxn,sigued bp dte ElecQnical
Com�b�actor o�t�iomeowncr(£o�installations allowed M be pe�t£armed by tLe homeow�ter)mASt bc sabnaitted :
wid�the paamit applicatio�a. A�p�carions snbinitned without an EIV whm sact�is re�nQCd,w�1 not bc
processed far Permit Lgsaance and w�bc rebaxx�ed far compledon. •
Job Addres.a � !1 � r r � Valae(i��wd����s�d�c«mia��0 bate '�1 �
Owner ��R(�' r(1�r�t_� Contractor �. ``, V 1'rl�j C.
OSin�le k'amiiy [�Dnplcx ❑1klniti-F'amily ORcutal Commercial ❑I�a tria�
Nunaber of�xtures: , �
ssthtub Sump PumP Plaster Sink Roof Drnin
Shmact Saa 3tnn1�'�D Scullcry Sink Sodn f)i.q�
Whirlpool vVatc Softcnc 9c�viee Si�k C�a Mk►
���, g�p�R� 9hamp Siek Site prain
Teild � Geragc FU &nBcats Sink Woitrg 5�
Kit Slnk L.ocal Waex Stcrilizd' ICC Cheat
. Dixposal esr S6�lc RPZ Velve Comm kc Mokcx
Bneakan 5ink Bide! lnt Grcaxc Trep
n�,� �e e�r�
FIOOr Drain Clnssrm 5inic Llrinel
Hote Bibb ���Q1k �*TeP Eye Wxd�Sln
�Vata Henta F 1'rep Slnk bipper well ���Q
CI Gna O 6kst Cl FwrVnt Floor 5ink brink Fem , Wtr ScwQ Mtr
Clotl�es W,�ehr Hand Sink " . Wash Ent+i '. � Wtr l3sagc Mtr
Lndry Tray 1+b 5ink Cntch 6aSin . Misc Fo�h�tos .
Elect�nic Contractor(for project,c not reqairing an ExV Form)
Use/Natnrc of Work��SrG/� T ���t.v. Q�,1 ���Q�
Siu Materia! Type #. _ Conn.Typc '
Sanitary Sewer
Storm Scwcr
Water Service
06/09