HomeMy WebLinkAbout0157964-Plumbing � CITY OF OSHKOSH No 157964
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2040 MENOMINEE DR Owner LARRY B/PEGGY D HIRSCHBERG Create Date 09/27/2013
Contractor D.R.HANSEN PLBG. Category 412-Res-Interior(New/Relocated Fixtures) Plan
Inspector Jerry Fabisch
Bathtub 0 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 1 San Sump/Pump 0 FIrIWst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 1 Water Soitner 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 Sculry Sink 0 Drink Ftn 0 int Grease Trap 0
Fioor 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/interior plumbing associated with the remodel of kitchen and bathroom
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer :
Water Service
Parcel Id#
1512030000
Valuation $1,800.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I
Issued By � Date 09/27/2013
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 55 KNAPP ST OSHKOSH WI 54902 -3448 Telephone Number 233-1595
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
]nspection Scrviccs Division ��
P O Box I 130 �
Usl�kosh,WI 54903-1130
Phone_(920)z36-5050
Fax:(920)23(r5084 � N
ONTHEW�iE�: ' I
Plumbing Permit l�pplication
T hereby apply for a permit to do and inst�ll the followirtg plumbing on the premises hereinafter deseribcd,the work to conform to lhc
Wisconsin 5lAtc Plumbing Codc,in the performance of which all partics hereto agree to and Are bound by said statutes.
• Application(s)and fee(s)ean bc brought to City Hall,Room 205 or mailed to Tnspcction Services,PaHox I 128,Oshkosh Wl
54903-1128. Commencing work without permit(s)will result in fees being doubled or�100.00 plas the normal permit fco,which
ev¢r is greater. �
� OR
/„�y_ou are a conlrac[or nQrl����ling in lhe Per�nit Fse Accv}��t svslem and have ad�u.a_le funds, check her� :
i f vou wanl Ihis nroce.ssed lhr���h veur r�ccount h
*�'Ad�issory�For applicabae�ojects, an Elec�ical In.Qtallat,io�ot Ve�ri�i'ication(EI��ox�aa,s�igned by the Electx�ical
Contractor or�o�eownex(for mstaIIations allowed to be perfoimed by the b�om�eowner)must bc snbm�itted
with thc pe�ottit applicadon. A�lications snbaputted withoat an EIV w�en snch is rcc�nircd� w�not be
processed for Pcrmit�ssnance a�ud w�l•bc rctnmcd fox coxnpletiion. � ,
Job Address .�v� d �Q i�1 aW►i n`<< Valq@(Includinglnborn „k,� ��i,> � lf �� ,U U ate 7�7 :
►
Owner Q �( � Contractor YI U ly� ��,
�SingJe Fam�ty []Auplcx Multi-Family ❑Rental ❑CommerciAl ❑X strial
Nuxtnber of Fixturec: .
Ba�h�uh • Sump Pump Was�tr Sink Ro�fDrain
Shawv � Sen.Sump/Pump Scullery Sink Sadn Disp
Whirlpool Weter SoRcncr Scrvicc Sink CoCfcc Mkr
f�vatory � Stendpipc Rec Sh�mp Sink Sitc Dmin
Tnilet � dnrngo Fl� 3urgcona Sink Waitrv$m T�
Kil Sink L,acal Wagtc Stcrili9.cr JcK Cheat
L�isposal 8ar 3ink RPZ Valvc
Comm lce Malccr
���y,�qh� Brrakrm Sink 9idel Tnt Grcave TraQ
Floor f�rain Clntsrm Sink Urintl H.xt Grcaac Tr:�p „�_
Ho4e Bibb fixam$ink � BcaTnp �yc Wach 5ui
Weter Heard• F Prq�Sink , Dipper Well bcducl Mcter
LJ(3Fts L]Elcct fl PwrVnl Floor 5ink Drink Fnp� �
Wtr Sewer Mtr �.__
Clotheg WgFtr Hand Sink ' _ Wa,eh Ent�f '. Wtr Unage MIr
f.ndry Trny I�b Sink Cntch i3azin Misc Fixn�r�
Electric CoQtractor(for�rojects�aot requiring an �ZV Form)
Use/Natu re o�'Work IM�c�2�
Sizc Macerial Type #_ „ Conn.Typc ;-
Senitary Sewer
Storm Scwer
Water$ervice
06/09