HomeMy WebLinkAbout2013-Plumbing (RPZ & deduct meter) � CITY OF OSHKOSH No 157258
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 177 N WASHBURN ST Owner MILLS PROPERTIES INC Create Date 08/16/2013
Contractor RADTKE 8�SONS INC,EDW F Category 442-Commercial-Interior(New/Relocated Fixt� Plan
Inspector Jon Mueller
Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 1
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 1 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 Flr/Wst 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 0 Breakrm Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature COMM/RP2 and deduct meter
of Work
""ck#27820"
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0614000000
Valuation $1,500.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided'
Issued By , Date 08/16/2013
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
Agent/Owner
Address 3730 N WOODSIDE CT APPLETON WI 54913 -7904 Telephone Number 920-733-7932
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
lnspection Services Division �
P O Box 1130 �
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084 HKO H
ON THF WATFR �
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 wark 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 participating in the Permit Fee Account Svstem and have adequate funds, check here
if vou want this processed through your account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the IIectrical :
Contractor or Homeowner(for installations allowed to be performed by the homeowner)mnst be snbmitted
with the permit applicadon. Applications submitted without an EIV when sach is reqnired,will not be
processed for Permit Issaance and will be retarned for completion.
Job Address 177 /(� ��}S k 1'�u 21v �l� VAIUe(Including labor and materials) �I��O- `, Date
Owner �1.�Ls �R�Pc�4't�,�� Contractor �i/�c� t 1-C�IO�I�C �- So-w s �� �a t 3r q
❑Single Family ❑Duplex ❑Multi-Family ORental �Commercial ❑Industrial
Number of Fiztures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San.Sump/Pump Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Coffee Mkr
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitrs Sfi
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve � Comm[ce Maker
Dishwasher Brealvm Sink Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trep
Hose Bibb Exam Sink Beer Tap Eye Wash Sm
Water Heater F Prep Sink Dipper Well Deduct Meter �_
❑Gas�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
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type # Corm.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09