HomeMy WebLinkAbout0158278-Plumbing (laterals) s
� CITY OF OSHKOSH No 158278 �
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD E
ON THE WATER
Job Address 3201 ELK RIDGE DR Owner Create Date 10/15l2013 '
Contractor IMMEL, ROBT J EXCAVATING INC Category 444-Commercial-Exterior Laterals Plan E7-513-0913-P
Inspector Jerry Fabisch
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 Flr/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 p
Disposal 0 Gar Drain 0 Plaster Sink 0 Dip Weli 0 Comm Ice Maker 0
Dishwashe� 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 COMM/Private Interceptor main sanitary sewer and water for apartment complex
of Work
I
Size Material Type # Conn.Type
Sanitary Sewer 8" Plastic Main 1 New
Storm Sewer
Water Service 8" Iron Main 1 New
Parcel Id#
Valuation $10,000.00 P proval $0.00 Permit Fees $100.00 ❑ Permit Voided',
Issued By Date 10/16/2013
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 �Tj,�„P.y „�� Date 1 G�-1,�-��
AgenUOwner
Address PO BOX 135 GREENVILLE WI 54942 -0000 Telephone Number 920-757-5906 '
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
Inspection Services Division �
P O Box ll 30
Oshkosh,WI 54903-1130 �
Pl�one: (920)236-5050 �
F�: �9�0>z'6-sog4 O.IHKO.IH
ON THE WATER
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 greater.
OR
If vou are a contractor narticinatine in the Permit Fee Account Svstem and have adeauate fi�nds check here
ilvou want thrs nrocessed through vour account �I
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
with the permit application. Applicadons snbmitted without an EIV when such is required, will not be
processed for Permit Issnance and will be returned for compledon.
.JOb L�(I(�CCSS__ J � � ) ��� 1�.��4 z �r• ViIIUC(Including labor and materiafs) 'Q� ���' Q 4 Date I a -1� - �,.3
Owner l�h,�l,�ttt l�r�c���, r.r,,� Contractor �•�, 2 r,..,�� L- x�.
❑Single Family ❑Duplez �Multi-Family ❑Rental ❑Commercial
❑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 Mkr
Iavatory Standpipe Rec Sham Sink
P Site Drain
Toilet Garage FD Surgeons Sink Waitrs Stn
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 Urina] Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Stn
Water Heater F Prep Sink Dipper Well Deduct Meter
-'Gas�Elect�PwrVnt Floor Sink Drink Fntn Wtr Sewer Mu
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type # Conn.Type
Sanitary Sewer � �\ ����" 'S���i
Storm Sewer
WaterService �' �� �V� �' - y' C1
06/09