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Home My WebLink About0158702-Plumbing (laterals) � CITY OF OSHKOSH No 158702 OSHKOSH PLUMBING PERMIT -APPUCATION AND RECORD ON THE WATER Job Address 1657 MARICOPA DR Owner TIM FREY Create Date 11/11/2013 Contractor DAVID TENOR CORP. _ _ Category 401 -Residential-Exterior(laterals) Plan I�spector 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. 0 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 UselNature New 8 Bed CBRF/exterior water,sewer and storm laterals for new CBRF � : of Work , I L–— I : Size Materiai Type # Conn.Type Sanitary Sewer 4" Plastic Lateral 1 New Storm Sewer 6" Plastic Lateral 1 New Water Service 4" Plastic Lateral 1 New Parcel Id# Valuation $15,000.00 Plan Approvai $0.00 Permit Fees $150.00 ❑ Permit Voided' Issued By v b - Date 11/11/2013 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 ea�sement holder(s)and to secure any necess als before starting such activity. �� Si nature Date AgenUOwner Address 2759 DEWEY DECKER DRIVE GREEN BAY WI 54313 -0000 Telephone Number 920-360-9246 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 1130 � Oshkosh,WI 54903-1130 Phone:(920)236-5050 Fax:(920)236-5084 Of HKOlH 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 1}'vou are a contractor particinating in the Permit Fee .9ccount System and have adeguatejunds, check here i�vou want this p�•ocessed throu�h vour account n **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 snbmitted with the permit application. Applications snbmitted without an EIV when such is required, will not be processed for Permit Issuance and will be retarned for completion. Job Address�/�/ `t^ /'/�r��`��l✓t Va�UC(Including labor and materials) ( J'��'� Date ` " �l� Owner �c� t�n ff��c�C�.� Contractor �� /c w�� Ce r/� ❑Single Family ❑Duplex ❑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 Lavatory Standpipe Rec Shamp Sink Site Drain Toilet Crnrage FD Surgeons Sink Waitrs Stn Kit Sink L,ocal Waste Sterilizer Ice Chest Disposal Bar Sink RPZ Valve Comm Ice Maker Dishwasher Breakrm Sink Bidet Int Grease Trap Floor Drain Classrm Sink Urinal Ext Grease Trap : Hose Bibb Exam Sink Beer Tap Eye Wash Sm Water Heater F Prep Sink Dipper Well Deduct Meter C Gas C Elect�PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr 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 y�� - Storm Sewer ��' �(l� Water Service y" 06/09