HomeMy WebLinkAbout2013-Plumbing (laterals) � CITY OF OSHKOSH No 157232
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1090 N WASHBURN ST Owner KWIK TRIP Create Date 08/15/2013
Contractor W&D NAVIS,INC Category q44-Commercial-Exterior Laterals Plan
Inspector Jerry Fabisch
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 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 p
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 8 Eye Wash Statn 0
Water Heater 0
Use/Nature COMM/exterior laterals for new Kwik Trip Store/all non-metallic piping underground will require tracer wire per
of Work code/install plumbing per plan review sheets/must have copy of approved plumbing plans onsite
**Occupancy permit will not be granted until easements are recorded for this property**
�"ck#1543'*
f
Size Material Type # Conn.Type
Sanitary Sewer 6" Plastic Main 1 New
Storm Sewer 18" Plastic Lateral 3 New =
Water Service 8" Iron Main 1 New
Parcel Id#
Valuation $111,000.00 Pian Approval $0.00 Permit Fees $322.00 ❑ Permit Voided I
Issued By �j J�y�_ Date 08/15/2013
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit applicati ithin an easement,the City strongly urges the permit applicant to contact the
easement holde nd to se a e als before starting such activity.
Signature Date g-/,,$=/�
AgenUOwner
Address PO BOX 48 WAUPAN WI 53963 -0000 Telephone Number 1-920-324-8995
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 1130 �
Oshkosh,WI 54903-1 1 30
Phone:(920)236-5050
F�:(920)236-5084 O�u�(O��.J
I 11\ I I
ON THE WATER �
Plumbing Permit Application
I hereby apply for a permit to do and install 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
54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which
ever is greater.
OR
If vou are a contractor narticipatin� in the Permit Fee Account Svstem a»d have adeauate funds check here
if vou want this processed throu�vour account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be snbmitted
with the permit application. Applications submitted without an EIV when such is reqnired, will not be
processed for Permit Issnance and will be returned for completion. :
/ Op :
Job Address /D�D /� �i4,S�O�//'.t�'a�lle(Includinglaborandmaterials) ��1. E7� Date �—fs —1�
Owner �i,�Jc� �r�;� L�� Contractor �.}�-p h(q,v,� .
❑Single Family ❑Dup ei x UMulti-Family ❑Rental [f�Commercial ❑Industrial
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San.Sump/Pump Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Coffee Mkr
Iavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitrs Stn
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher Breakrm Sink Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Stn '
Water Heater F Prep Sink Dipper Well Deduct Meter
G Gas C Elect C PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray L,ab Sink Catch Basin � Misc Fistures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type # Conn.Type
SanitarySewer (P`..k.��` ��� r���_�
Storm Sewer �'.� j�^ �JL�.�.{b�� 5 l>1�-3 S
Water Service �,"-y'!.�'' �� �+- C���,.�,T
06/09