HomeMy WebLinkAbout0157801-Plumbing (sump pump) � CITY OF OSHKOSH No �5�so� :
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1006 EVANS ST Owner B LEE POGUE Create Date 09/18/2013
Contractor M P KELLY _ Category 413-Res-Interior(Replacement Fixtures) Plan
Inspector Jon Mueller
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 1 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. p
Toilet 0 Water Softner
Kit Sink 0 Standp Rec 0 Lab Sink 0 Beer Tap 0 Ice Chest p
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/replace sump pump —
of Work
'*ck#12921'*
� �
Size Materiai Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1108610000
Valuation $426.00 Plan Approval _ $0.00 Permit Fees $30.00 ❑ Permit Voided�I
Issued By Date 09/18l2013
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 665 N MAIN ST OSHKOSH WI 54901 -4431 Telephone Number 231-1750
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 S E P 19 2013
Inspection Services Division �
P O Box 1130 �
Oshkosh,WI 54903-1130 DEPARTME'eT OF
Phone:(920)236-5050 COVI�TUNTTY UEVELOP11EVT
Fax:(920)236-5084 INSPECTiON SERViCES Di�'1SIOV O.IHK�
ON TNF 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 work without pernut(s)will result in fees being doubled or$100.00 plus the normal pernut fee,which
ever is greater.
OR
I�you are a contractor participating in the Permit Fee Account Svstem and have adeguate funds, check here
if you want this processed through vour account n
**Advisory-Far applicable projects, an Eleckrical Installarion Verification(F.IV)form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Pernut Issuance and will be returned for completion.
Job Address �J✓ VRIUe(Including labor and materials ��v Date��`� �
�O ner L�,� Contractor
fi'�[gle Family ❑D lex ❑Multi-Family ❑Rental Comm cial ❑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 M1Q
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Gazage FD Surgeons Sink Waitrs Sm
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher Breakrm Sink Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Sm
Water Heater F Prep Sink Dipper Well Deduct Meter
�J Gas C]Elect t7 PwrVnt Floor Sink Drink Fnm Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr :
��'Y T�Y Lab Sink Catch Basin Misc Fixtures
Electric Contractor(for projects not equiri n EIV Form)
Use/Nature of Work
Size Material Type # Conn.Type
Sanitary Sewer
� _a,,
Storm Sewer �''
Water Service ^�
06/09