HomeMy WebLinkAbout0157769-Plumbing (urinal) � CITY OF OSHKOSH No 157769
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1485 W 20TH AVE Owner DAVID L MARSHALL Create Date 09/17/2013
Contractor D.R.HANSEN PLBG. Category 442-Commercial-Interior(New/Relocated Fixt� 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. 0 :
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 1 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 Eut 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/replace urinal
of Work
i
J
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1323090000
Valuation $1,100.00 Plan Approval _ $0.00 Permit Fees $30.00 ❑ Permit Voided '
Issued By �� Date 09/17/2013
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 performed within two business days from the time the project is ready.
Ciry of Oshkosh �
�nsptx:tion Servicac D'IVicion �
P O Box 1130
Oshkosh,WI 54903-L 130
Phonc:(920)236-SOSO ���
Fax:(920)236-5084 oN r►+E wnT�R
Plumbing Permit �Pplication
1 hcceby apDf3'�r e P�"it to do and instal�thc following plumbing on the promisc�ha�ciaaftc�'deRCrib�d,the work to conform to the
W ixconsin State Plumbin�Code,in dte performanee of which all partisc hCreto agree to and are bound by said statutes.
• pppl;c�tion(s)and f�ce(s)can be braught to City Hall,Room 205 or mailed to Inspection Scrvioos,'1'O Bex 1128,Oshkosh W1 ;
54903-1128. Commencing work withouc pa'tr►it(s)wi��rault in fees being doubled or z100.00 plu�the normal permit fee,wh�ch
evcf 19 g��.
OR
�„ �l�e
,(�vou Qre p ca»�raclor na►'ticrDCUi»P �ermit 1%ee �Jccoun� Svsfe►n and have ade�UO1e fr��ds ctiec_��
il vo_y wa�� lhis nroc sced lhrot,�rh vo�rgC���rrtl
**Advi9ozy-Frnr app�icable�roj�,aoo�ElecGoical�nstat�a�irna VeniEcation(E�V}Fa�nm,signed b�tbe ElecOnical
Co�atractox or�omeoane�r(for i�tstallatxons allowed to bc pe�otmcd by thc homcowner)mnst bc sv.bmitted
hca�ions snbmutted wiithout en E�V wh�n sncl�is rc�nired,�aot be
wiRb thc�cnaouit applicati�on. A,pp '
p�occssed for Pc�it L�aamee��d�b tetntned�'or cotnpletioz�. . �
w � - V A��e(Irroluding labtu s�d materiels)�/ �� DO �at� �
Job A,ddress L
Owner Cir � Contractor
❑Cingle F9mily DAuplcx ❑Malti-Family D�t�ntal (,�Commercial ❑
nstrial
Naroiber of Fbttur�c: ,
� 5��P Plastcr Sink Reof Drnin
Showor San,S�onP/PumP
9cutlery Sink Soda D�R+
Whirlpool Water So4t��x
Scrvicc Sink Coftoe Mkr
g���R� Shomp Sink Site Arain
I,nvatory
.. �.��� gargepn.a Sink Waitra 3�
Toilol
�W�� 5tcrlli�rr tx Ch��
Kic Slnk
Disposal
B�Sink RPZ Valve Ccxnm Icc Makor
Brrelmn Sink BiAa lnl Grease Trep
D�ghwe6hcr Bxt Grmx TraP
Claeaxm Sink Urinel �
Floor ArAin Eyo Wash S�n
Sxun Sink BcerTsp
Hcr.cc Bibb p��M�
Wster Hmtcr F Prep Sielc DiPPer P+dl
[I GaA O Ekct C1 PwrVM Floor Sink Drink Fnai , Wtr Scwe�Mv
Cldhes Wsfr Hand Si� ' . Wash Fnm ,. . VJtr Usago Mtr
1.ndry Tray l,ab Slnk Cntch Basin � , Miac Fixt►ne.t
Electric Contractor(for projects aot rcquiring an EIV�'orm)
Use/Naturc of Work CL C U r�hC � .
Sizc Material Typc #_ „ Conn_Type ,r
Sanitary Sewcr
Storm Sewer
Watcr Scrvicc
O6/09