HomeMy WebLinkAbout0158521-Plumbing (sump pump) � CITY OF OSHKOSH No 158521
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 902 WINDWARD CT _ Owner THEODORE W/CAROL A HOFF Create Date 10/29/2013
Contractor D R GLAZE PLUMBING _ Category 413-Res-Interior(Replacement Fixtures) Pian
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 1 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 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 SFR/replace sump pump -
of Work �
"ck#1239" :
I
Size Materiai Type # Conn.Type
Sanitary Sewer ,
Storm Sewer
Water Service
Parcel Id#
1522440000
Valuation $275.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By JI^/�� 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 1865 JAMES RD OSHKOSH WI 54904 -6873 Telephone Number 920-589-4014
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.
Ciiy ofOsl�kosh
Irnpection Sers�ices Division �� (���
P O Boa 1136 3 �
Osl�cosh�'I 54903-113d (o��-��� ��� �
Phone:(92t�}236-SC35Q �'�
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Plumbing Perm�t Application
I herzb�-a��h�far a penmt to da arid a3stall tt�follo�s�a�p�nr�ir�on the prenv..Ges hereinafter descr�bed,tY��ror�to rnrltorm to the
t�'iscansin State Phm�birrg�:ade,a�tl�perforn�nce of«hich all�art��Y�reta agr�ta and are boun�i by said siatutes.
• A�glicatiar�s3 and fee(s}canl��hrouugttrt ta G�y Hall Room ZQS ar mailed to Ir�pection Sers�-ices,PO Ba�i 1'S.�shkosl�lt'I
5=�903-11�8. Gorrur�er�eazg u-ork��-uhout penr�i[(s j��-�1:resu}t m fees heict�doub�d ar S i C�a.CsO phu the non�l pennit fee,«-lv���
e�-�r is greater.
OR
�ioir ar,e r� cofrtrne�o= �c�rtici,�at�r1�in t��e Perrntr Fee .4ecai�f�t Si�stern aird laace acle�t�at���ds� clzer� f1er� �
i�iopr i�a�rt tlris p7-ocessed rh�•o��Qh tazs�°_ACC�t�n*❑
*�Advisc�ry-For applicable grojects, an Electrical Installation Verification(EIV)form, signed by the Electrical
Confiractc�x�or Homeowner(for installarions�allowed to be performed by the homeowner}must'�e submitted
with the pern�it application. Applicativns submitted witha�t an EIV when sueh is required,will nat be
pracessed for Pernut Issuance and�vill be returned€ar completion
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La�atory _._--. Siatidgipe Rec __.___ Shan�Sinli --,--...... $rte Ihaai
Tcikt ___.---_. Gara�e FD Sur�eans 5ink __ R'aitrs Stn _
kg Siril: Localii'aste ____ Sterilizer Ic?Chest __!
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Drh�vashzr Bre�rxn Sa�I: Bidet __ Int Grease Irag ------
Fbs Ikaaa _ _____. Ctas�rcnSa�ic __._____, t:ra�al __-- ExiGrrase Trag
Hese B�b E�am S i�.l: ____ Beer Tag ----.- Eye«'ash Sm
t�'atnHeater FPrepSiii: --- ��FP�Zj"eIl _ De�cxlIcter ---
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Lr�gTray LaL�Sa�t: _.---- GatchBasa7 ___.__ \fisc Fixn:re_
Electric Gontractor(for projects not requi��g an�IZ"Form)
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