HomeMy WebLinkAbout0157921-Plumbing (water lateral) � CITY OF OSHKOSH No 157921
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1300 1302 CONGRESS AVE Owner RAUL C/ROBYN L TALAVERA JR Create Date 09/25/2013
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 Orain 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 FldWst 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 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 SFR/repair water lateral
of Work
""debit acct"'
i
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service 1" Plastic Lateral 1 Repaii
Parcel Id#
1205000000
Valuation $1,000.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided�i
Issued By ��1/V Date 09/25/2013
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the Ciry 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 pertormed within two business days from the time the project is ready.
City of Oshkosh �
inspcction Scrvic�Divlslon
P O Box 1130 �
Oshkosh,WI 54903-1130
Phone:(920)236-5050 � �
Fax:(920)236-50$4
ON TME W�TER
Riumbing Permit �pplication
I hcreby apply for a permit ta do and install thc following plumbing on tfie premi.�hcreiunfter dcscribed,thc w�ork to conform to the
Wisconsin Statc�lumbing Code,in d�e performancc of which all partics hertto agrec to and arc bound by said statutes.
• Appliestcion(s)and�ee(s)can be brouglrt to City Hall,Room 205 or mailed to inspectiott Servicos,PO Sox 1128,Oshkosh WI
54903-1128. Commencing work without permit(s)will raault in faes beiag daubled or�100.00 plus thc norm�l p�rm�t�'e�,which
cver is�eatcr.
OR :
If�ere a co [raclor nar��crpatin in the Perr�tt Fee �ccounl S�slern and have ade_o�gte_ und . ch�ck_h,�;¢
if vg� wQnt th's nrocesse��hroV your acc4f�Mt_�
**,,�dviso�y_For�plicable projects, an F�cc�ical Iiastallation Ycrificati�rnn(F�I�Farm,sigacd by d�e HeeO�ica1
ConitKactor ar Homcownex'(�v�r instx�la�tians aYlowed to be pet�ormed by th�homeo'wncr)must bc snbmitted
with thc peuoa�itt a�lic�at�ioxt. Applic�ons sabmxt'tcd withoat an EIV when sacb��1s x'eqnired,w�71 not be
processed for Pexn�Q Lssaauce and wxU bc rct.amed�ox comp�etion. � ,
Job Add � 3�� 0� S S VBIpC(inelod'mg Mborand maeaials) I�oo•� Date� � ��
Owner �Q U p►'� Contrsctor �, Cr! V �lh L�-L
[�Singlc Family []Duplc�r �Mu�ti-�'amily ORcntea ❑Co�tnercial Indosh-i91
Nnmber of F'rxtares: '
Ba�hhtb Sump Pump rlsster Sink RnofUain
Showcr San.3umplPump 5culldy Sink Sada Disp
Whlrlpool Water 3ofta�c Scrvice Sink Cofl'm Mkr
Lavatury Stsndplpc Rec 5hamp Slnk 3itc ThAm :
Toilel � GnmRo FD Surgeona Sink Waids 3m
KIt Sink Loca1 Waatc ScQiliz�r Icc Cbe�c
_ Dispoael BM C'v�k RPZ Va�ve Comm la Maker
17iqhwoat�er Brcakrm Sink Bidd fnt Greae Tras+
Floor Drain ClsAarm Sink Urinnl FS+ct Grease Tr�►
Hose Bibb E�m Smk Bop'Tnp 5ye Waxh Stn
Water Heecar F Prcp 3ink Dlpper DVoll Dedua Mcta
U Ges u Eleet Cl PwrVrrt Flvor Sink brink Fnm wv 9ewe�Mtr
Clochcs wshr Hand Sink � . Wa�ah F.�, : Wtr Usago Mtr
(,ndry Tray [eb Sink CatcN F�s�n , Milac Fixm�ra
Electric Cantracto�(for pr 'ccts not rcqniring s�a E�V Form) :
Use/Natnre of Work �Y Y[�;C.0
Sizc Materisl Type �_ „ Conn.Type ;'
Sanitary Sewcr
Storm Sewer
Watcr Scrvicc
06/U9