HomeMy WebLinkAbout0157264-Plumbing (Dishwasher) � CITY OF OSHKOSH No 1s�2sa
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 673 FREDERICK ST Owner DANNA L ROSENTHAL Create Date 08/16/2013
Contractor WOLF&SONS PLUMBING LLC. Category 412-Res-Interior(New/Relocated Fixtures) 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 0
Disposal _ 0 Gar Drain 0 Plaster Sink 0 Dip Well 0 Comm Ice Maker 0
Dishwasher 1 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 0 Eye Wash Statn 0
Water Heater 0
Use/Nature iSFR/instal�ing new dishwasher
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0704320000
Valuation $500.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided i
Issued By � Date 08/16/2013
In the performance of this work, I agr to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no uthority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit applica' n within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and t s ure any necessary approvals before starting such activity. '
Signature Date ��� -��
AgenUOwner '
Address 130 W.FRANKLIN AVE. UNIT#741 NEENAH WI 54957 -0741 Telephone Number 920-379-9772
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 54903-1130
Phone: (920)236-5050 ,
Fax:(920)236-5084 OJI--IKO f 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 al(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 participatinQ in !he Permit Fee Account System and have adeguate fi�nds check here �
if vou want ihis processed throu�vour account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form,signed by the Electrical
Contractor or Homeowner(for installadons allowed to be performed by the homeowner)must be snbmitted
with the permit application. Applications snbmitted without an EIV when such is required, will not be
processed for Permit Issnance and will be retarned for completion.
Job Address d � � �r���/���� Va�Ue(Including labor and materials) �� ' G� Date �/ � 6 �/ �
Owner v4,,,,ti /Za1�,f�w� Contractor ��� � e S� ��
❑Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San.Sump/Pun�p Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Coffee Mkr
Lavatory 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 i� 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
�Gas C Elect 0 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Etectric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work �l�r/ /�p����
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09
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