HomeMy WebLinkAbout0157660-Plumbing (bathtub) � CITY OF OSHKOSH No 157660
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1324 W 9TH AVE Owner JEFFREY S/LUAN K PETERSON Create Date 09/11/2013
Contractor REBATH OF CENTRAL WISCONSiN Category 413-Res-Interior(Replacement Fixtures) Plan
Inspector Jon Mueller
Bathtub 1 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 0 Lndry T�ay 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 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 Scuiry 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/replace bathtub
of Work
"debit acct"
_ �
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0608560000
Valuation $400.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I
Issued By �LYL. Date 09/11/2013
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address 230 N KOELLER ST OSHKOSH WI 54902 -4104 Telephone Number (920)765-0068
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
Sep, 11, 2013.. 11 : 05AM . REBATH CENTRAL WI 9203035935 . � � No. 4529'!• P. 3/4i�►
. . ...: . . ' � . . • . ON Ti�� .�,..,cR .
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: .:. . Pl�r�b�� Per�tr�.A � 6.acati:Qn. . . ;: �..
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� .:..:. I�ereby.apply for.a.pe�mit to.do and.inscall the�;Followina plumbing on the.premises hereinaf�er described, the work to�confonn to the'
Wisconsin State PluAabmg Code;in the performance of ivhich all parties hereio agree to and are boiirid by said statutes,
.� •: Applicarion.(s)and.fee(s)can be brou�t.to City Hall,Room?OS or mailed to Tnspection Services,PO aox l 128,Oshkosh WI
54903-1128. Com3nencing work without permit(s)r��ill resuZt in,fees being doubled or$)00.00 pIus�nc�normal,perin;t fee,which
ever is gearer. . . :
. . OFt . . ,
� I ou are a contratior artici alrn in the Permit Fee Accoun� S' stem and have ade uate unds check here
i{vou want this proeessed throu�h vnur acc.ou�t n �
: '"*Acivzsorp-For.applicable projects, axt�Ieedric.�l IustallatiQ�e'�'ersfxcatron(EIVj form, sigaed by tlxe EleetricaI
Coniraetor ox'Homeovc�ner(fox'installatians aJlowed to be perfonreed by the hameowner)�be��tted '
witli the perz�zzt applir�'�n, Agp�caCioBS subzz�ztted witbout an EI'V�aFiezz s�cb is recpssed, will not be
processed for Peanit Xssuance and will be retnrned foz completion. �
Job Address�_� � ' �� �VAIUe(ir►dudine Is�bor snd mrytcriflls) - � �?ate l�C�'1,3
. Ovvner� � ��� Coz�tractor��1��aMG�S•JD�L;-"�l.l�?5 �- :�A�7�} E
�SingIe Famfly �Duplez dNlutti-Famrly ORenta.l ❑Cotn�tnercial ���uditstrial ,
Number of Fi��es:.
B� r�. Sump PumA Plastu Sm}:' ' Roof Dreln '
Shower San.Sump/pump � Scullery Sink Soda Di
SD
Whiripool 1L%ater Sofrcncr 5crvice 5ink Coffee ivifv
Lavatory Standpipe Rec Shamp Sidk. 3ite Ihain
Ta1et (}ara,�e k1J , . Surgeocss Sinl:: Waitrs Sm .
K;t S;nk Loca(Waste Steriliae` ' Ice Chcst
. p+�P�� B�Sink RPZ Valve Comm lce Mefcnr
�Dishwsshcr Brcalam SIIJc "aidct Int Grease Trap
F7oor�rain . Classrm Smk Urinal Ext Grease Trap . .
Hose Bibb ' Erani Sink Beu Tap . EYc Wash Sm .
' R!azer Heater 'F Prep Smk ' DiDDcr Well Dcduct Merer •
•0 Gas 0 Elecx�PwrVrit Floor Sink Drink Fnm" Wv 5ew�r Mff
Clotbes Wsltr . . _..
... ...:. .. .. HandSink.: . ..._ . ..._.
. . ...:.. . . _._._. .._.._ . . .
�'-�.'�ish�AI� Wu Us�Mtr
_ . I-n�5.?.�Y_.... . .:_._..ZabSink._........ . . � . ._..CatchB,asin----... :.. ... • ---.
. . . .. . t�;s�r:-
._. ......
. _... �... ..... .
.. ._.
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Efectrsc �onEra��or��far proje�s n�ot req�r��g an�I'V�or�} . - ..._
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Use/Natrire.of'4�ork . . .�.. .. .... : _.. :.:......._..---�::._... _ —-.... .. ._ .. _ _..
� ........ - Size Material Ty��. ..; . # Conn.Type'
Sanitary Sewe� � , . � � . . .
StozAnl Se�yer • , � �, .
. yvater Service ; � � .
. . . .. . . . . ." . . ; . . 6.
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0 /09 , .'