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Home My WebLink About2013-Plumbing (repair cross connection) � CITY OF OSHKOSH No 158511 ' OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 2920 N MAIN ST Owner KHOF ACQUISITIONS INC Create Date 10/29/2013 Contractor KURT ZENTNER 8 SONS INC Category 440-Industrial-Interior Plan Inspector Jon Mueller Bathtub 0 Clothes Wshr 0 Ciassrm 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 11 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. 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 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 iND/repair cross connection issues per Hydro Design survey of Work 'debit acct** Size Material Type # Conn.Type . Sanitary Sewer Storm Sewer Water Service Parcel Id# 1519600600 Valuation $12,000.00 Plan Approval $0.00 Permit Fees $99.00 ❑ Permit Voided'i Issued By �� Date 10/29/2013 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 2860 OREGON ST OSHKOSH WI 54902 -7136 Telephone Number 235-1340 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. i City of Oshkosh � Inspection Services bivision � P 0 Box 1130 Oshkosh,WI54903-1130 Phone:(920)236-5050 �II O�� Fax:(920)236-5084 I I Qh TMr:v17FR Plumbing Permit Application (hereby 3pply for a permit to do and install the following plumbing on thc premises hereitlatter described,the work to conform to the Wisconsin State Plumbing Code,in the performance of which all partics hereto agree Co and are bound by said statutes- • Application(s)and fee(s)can be brougM to City Hall,Room 205 or mailed to Tnspection Services,PO Box 1128,Oshkosh WI 54903-1128. Commcncing work without permit(s)will resutt in fees being doubled or$104.00 plus the normal perR►it fec,which ever is greater. / au re a c ntOractor artict atin in �he Permit Fee Aceount S stem nd h ve ade upte unds c eck h re r ou want rhis rocessed throu h our ccount **Advisoxy-For applicabYe projects, an Electrieal Tttstaliation''Vtrification(EI�form, signed by the Electrical Contractor or Hom�owner(for�nstallarions allowed to be pe�ormed by the homeownes)must be snbm�tted wiCh the permit application. Applicacions submirted�cvithout an EIV when such is Ycqnaed,w�l not be pxocessed for Permit Issnamee and wi71 be reta�raed for completion. � rob Address � � � A� � �aIUC(Including labor end materials) � �� Date/fl Za � Uwner �{�. Co�ntraCtor � � �'O" Connmercial ustrial ❑Single�amily ❑Duplex []Multi-�'apnily ORenta� ❑ � Number of Fixtures: 8athtub $ump PumP Plascer Sink lioof Drain Shower S3�t.Sump/Pump Scullery Sink Sode Disp Whirlpool Wacer Softener Service S� Coffee Mkr [,avatory Standpipe R�� Shamp Sink Site Drain Toile� Garage FD 3urgeons Sink Waius Stn Local Westc Steriliur IC�Chest Ki�Sink � Bar Sink RPZ Valve Comm lce Maker Diaposal int Grease Trap Breaktm Sink Bide[ Dishwasher Clrinal Exc Grease T�ap �loor D�ain Classrm Sink Hosc Bibb Exam Sink Beer Tap Eye W ash Sm � F Prep Sink Dipper We11 Deduc�Meter Wa�er Heacer Wa Sewe�M�r L Qes❑ElecC 0 PWrVnc Floor Sink brink Fnm w�h p�� Wtr�Ussge Mu Ctothes WsAr Hand Sink 'Lndry Tray T.sb S+nk Catch Basin Mi��r�" Electric Contractor(for projects not requiriag an ETY Form) Use/Nat�re of Work /�` �'�" l v Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Scrvice 06/09