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Home My WebLink About0157799-Plumbing (eye wash) � � CITY OF OSHKOSH No 157799 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 3500 N MAIN ST Owner PERFECSEAL INC Create Date 09/18/2013 Contractor M P KELLY Category 442-Commercial-Interior(New/Relocated Fixt� 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 0 F Prep Sink 0 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0 Lavatory 0 San Sump/Pump 0 FIr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. p Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. � Fixtures Kit Sink 0 Standp Rec 0 Lab Sink 0 Beer Tap 0 Ice Chest 0 Disposal 0 Gar Drain 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 1 Water Heater 0 Use/Nature COMM/install eyewash of Work I'*ck#12921" I I Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# 1519603301 Valuation $1,432.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided'� issued By ',fV�-- Date 09l18/2013 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 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. 12ECEIVED � . �. ��'�'�, ��C. SEP 19 2013 CityofOshkosh 665 N. MAIN STREET Inspection Services Division 0 S H KQ S H, W I S C. 5490� P O BOx 1130 DEP�RT;�tE COM�iUrITY DE� OShkOSh,WI 54903-1130 INSPECTiOV SERVI Phone:(920)236-5050 Fax:(920)236-5084 O HK � H ON THF 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 permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which ever is geater. OR If vou are a contractor participatin in the Permit Fee Account Svstem and have adeguate funds, check here �vou want this processed through your account [1 **Advisory-For applicable projects, aa Electrical Installation Verification(EI�form, signed by the Electrical Contractar or Homeowner(for installations allowed to be performed by the homeowner)must be snbmitted with the permit application. Applications submitted without an EIV when such is required,will not be processed for Permit Issuance an ill be returned for completion. _ 2�b � Job AddreS�SJ�/� VRille(Including labor and t als) �� Date Owner Contractor ❑Single Fami y Duplex ❑Multi-Family ❑R ntal m cial ❑Industrial Number of Fixtures: Bathhtb Sump Pump Plaster Sink Roof Drain Shower San.Sump/Pump Scullery Sink Soda Disp Whirlpool Water Softener Service Sink Coffee Mkr I.avatory Standpipe Rec Shamp Sink Site Drain Toilet Gazage FD Surgeons Sink Waitrs Sm Kit Sink Local Waste Sterilizer Ice Chesc Disposal Baz Sink RPZ Valve Comm Ice Maker Dishwasher Breakrm Sink Bidet Int Grease Trap Floor Drain Classrm Sirik Urinal Ext Grease Trap Hose Bibb Exam Sink Beer Tap Eye Wash Stn � Water Heater F Prep Sink Dipper Well Deduct Meter ❑Gas Cl Elect�7 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr Clothes Wshr Hand Sink Wash Fnm Wtr Usage Mtr ��Y T�Y I.ab Sink Catch Basin Misc Fixtures Electric Contractor(for proj cts not re uirin an EIV For . Use/Nature of Work Size Material Type # Conn.Type Sanitary Sewer -� Storm Sewer ��'� � Water Service �� 06/09