HomeMy WebLinkAbout0158004-Plumbing � CITY OF OSHKOSH No �ssooa
OSHKOSH PLUMBING PERMIT -APPUCATION AND RECORD
ON THE WATER
Job Address 904 MOUNT VERNON ST Owner RYAN D ANDERSON Create Date 09/30/2013
Contractor C SWEETING PLUMBING LLC Category 412-Res-Interior(New/Relocated Fixtures) Plan
Inspector Jon Mueller
Bathtub 1 Clothes Wshr 1 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 1 Lndry Tray 0 Exam Sink 0 Sterilizer 0 Soda Oisp 0 Wtr Sewer Mtrs 0
Whirlpool 0 Sump Pump 0 F Prep Sink 0 RP2 Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 1 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. p
Toilet 1 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. � Fixtures
Kit Sink 1 Standp Rec 2 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 SFR/plumbing associated with interior remodel
of Work
j"debit acct**
I .
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1002410000
Valuation $3,000.00 Plan Approval $0.00 Permit Fees $81.00 ❑ Permit Voided I
Issued By �- Date 09/30/2013
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
AgenUOwner
Address 1583 COUNTRY MEADOW CT OSHKOSH WI 54904 -9316 Telephone Number 920-410-4017
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
Fa�c:(920)236-5084 O HK01H
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 ll28,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
I ou are a contractor artici atin in the Permit Fee Account S stem and have ade uate zrnds check here
i ou want this rocessed throu h our account
**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)mnst be snbmitted
with the permit application. Applications sabmitted without an EIV when such is reqnired, will not be
processed for Permit Issaance and will be returned for completion.
Job Address �� p�y
90 y �r���Kd� Va�UC(Including labor and materials) 3� 6��� Date / t7�'��3
,.
Owner /�•-r,.-rr! �i�,,��✓3�st- Contractor �—_j:��--�•�� 1�/�S-
�]Single Family ❑Duplez ❑Multi-Family �Rental ❑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
Lavatory � Standpipe Rec �_ Shamp Sink Site Drain
Toilet l Garage FD Surgeons Sink Waitrs Stn
Kit Sink f L,ocal Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher .r Breakrm Sink Bidet [nt 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
C Gas G 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 Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work c.�-f�/
, �'�"''
Size Material Type # Co n'.`Type
Sanitary Sewer S E P 3 0 2013
Storm Sewer '
Water Service n��aRT�te�r oF
CO�i`.IL'�TTI'L����LOP� EVT
- R\'ICES DI '1510�
06/09