HomeMy WebLinkAbout0157823-Plumbing � CITY OF OSHKOSH No �5�s23
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1171 PARK RIDGE AVE Owner PETER M/ELLEN K MOLL Create Date 09/19/2013
Contrector REBATH OF CENTRAL WISCONSIN Category 412-Res-Interior(New/Relocated Fixtures) Plan
Inspector Jon Mueller
Bathtub 1 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 1 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 2 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. p
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
Disposai 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 1 Bar Sink 0 Serv Sink 0 Wash Ftn 0 Ext Grease Trap 0
Hose Bibb 0 Breakrtn Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature SFR/remodel(2)bathrooms with new fixtures
of Work
"debit acct"*
I
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1222550000
Valuation $500.00 Plan Approval $0.00 Permit Fees $45.00 ❑ Permit Voided
Issued By ��(/1.. Date 09/19/2013
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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. 18 2013: 4: 29PM . REBATH CENTRAL WI 9203035935 .. ��: .... No. 4559yNTHP� 2/2=
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: . . . .:�. P[un�l�ing E�er�it A�p[ica�iQr�. ; : , . ;
.. I heireby apply for:a permit to do and install#he�following plumbing on the premises hcr�inafter described,.the work to conform.to the� .. ;
'�.'Wisconsin St�se Plumbinb Code;im,the perfornnance of which all parties hereto agee to;and are bound by said statutes.. .
` •. .Application(s)and fcc(s)can be brouaht xo City.Hall,Room 205 or mailed to Inspecuon Services,PO Box 1128;.Oshkosh Wl
54903-1128. Cominencing work wirhout permit{s)willresult in fces being doubled or�100_00 plus the normal permit fee,which
: ever is:greater. " � . - � ; . ,
� OR ° .
Ifvou are a contractor �articipatrri; in the Permit Fee slccoun� Svstent and have adeauare funds,�che.ek here
ifvou want this z�rocessed through vour account �
�*�d�vzsory-Far applicable pro3eccs; a�Etec�tri.c�al Ix�estalla.trQ���eriffcattats(L��fazm, sigzzed by the ElecrrieaI
Contxactor or Ao�zeowner(for instaIIabions atlowed ta be pe�rfarmed bp the ho�cawner)mnst be sabmitted '
with the.permit ap�lication. Applic�ozis sabmitted withoat an.EIV R'he�suc�t zs recguired, wiF1 not be
processed for Pertnit Lssuance and wiJ1 be retu.rned for corn�pletion. � � .
�Job Address` �. �Value(��i�d��iabor�a�„�c���j ��� ��� �?ate �' ��
. Owmer �,���l _ Cantractor��lf1 eS Q�� �i�
�ingle JF'amily �baplex [�ll�ulti-Fa�miEy QRentsil ❑Cocz�mercial OTndustrial
11T.�u�mber o�'Fixtures: .
BachLub J.=��// S�unp Ptunp Plastar Sink`. Roof Drain '
Shower ��/ Saa Sump/Puotp Scullery Sink Soda Disp
�'nirlpooi _� W"�et Soficncs 5ervice Si�tk .Collee�blkr
Lavawry � Srendpipe R�cc Sh�np Siak. .. Sae Drain
Toilet (3arage FD, .. . ' Surgeoas Sink, ° Wa;trs$tn
ICit 3mk Lor.al Waste Steriliru 1cc Chess : '
Disposal B�c Si�Jc RPZ Valve Comm!ce Maku
Dishw�sher BrcalQm Sink . 'Bidet . lrrc Crceasc Trap ..
Floor Drnia �J Classtm S�k , . Urmal Ext Greasc Trap �
Hose Bibb •. �m Sink Beer Tap � Eye Wach Str� '
�Wac�r Hem.er F Prep Sink DrPV�Well . Deduc[Me�u
D Gas❑FJect 0 PwrVot Floor Siok •Dnnk Fnm � , Wff Sewer Mv
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Clorhes WsLr Hand Sink Wach Fntn ........__._.._.. _....__.... vVtr Usage Mv.. .. .. _.._.
---._...._I.ndi}!T,ny_ .. ._:.:_.._.L.ab.Siak-..-•.-:.._.:... . . . .. _.__..CatcbBasiu.__:_._... .. :_.M�sc Ei�au,es . :
Electr�c Coi�tractor(for proJects not rec��ri�g�u E]'iV TN ar�) . .
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��Jse T�TVateire bf'PVark_ .
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� Size :.Ma'terial' ' ' Tyrie,. � . #, - : ' .. Cotta.Type '
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Sanirary Sewer . . .. .. . .
Storm Sewcr , .
. .Water 5ervice . ' ..
. ,. ' . . 06/09