HomeMy WebLinkAbout0158781-Plumbing (storm drain & catch basin) � CITY OF OSHKOSH No 158781
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 137 ALGOMA BLVD Owner FIRST CONGREGATIONAL CHURCH OF OSHk Create Date 11/15/2013
Contractor D.R.HANSEN PLBG. _ Category 401 -Residential-Exterior(laterals) Plan
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
Whiripool 0 Sump Pump 0 F Prep Sink _ 0 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 FIrIWst 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 1 Eye Wash Statn 0
Water Heater 0
Use/Nature COMM/install 6"storm drain and catch basin 1
of Work
;"debit acct"
I
�_
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer 6" Plastic Lateral 1 New
Water Service
Parcel Id#
0100980000
Valuation $10,000.00 Pian Approval $0.00 Permit Fees $59.00 ❑ Permit Voided
Issued By �J�/1�l- Date 11/15/2013
In the performance of this worlc, 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.
;
Ciry of Oshkosh �
lnspection Servioes Dtvisioo �
P 0 8ox 1130
Oshkosh,W154903-1130
Phone:(920)Z36-5050 H
Fax:(920)236-5084
ON TH�W/1TER
Plumbing Permit A�pplication
I hereby epply for a permit to do and install tho following Plumbing on the premises hcreinafter described,the work tio conPorr"to the
Wisconsin State Plumbing Code,in the perFormance of which all parties hcreto agrce to and are bound by said staanes.
• qpplicaaon(s)and fee(s)can be brou�t to City�Hall,Rooro 2U5 or m�iled to inspection Services,PO Box 1128,Oshkosh Wi
54903-I 128. Commencing wo�k without pertnit{s)will result in fee,s being doubled ar$100.00 plus the normwl permic fee,which
everis greater.
OR
ff vou �re a_ nlra (pr patl�cipa Fn� i�111e PermE! Fee Accou�E�!.��d Ve a ual unds_ h c ere
if vou wan! lhis »roc¢s� !hr h r acc n�
**Advisoxy�Fox applicablc projccts, an Electirical Ittstallatio�Ytri�iicatio�n�(F.IV)foxm�signcd by the Elec�ic�
Co�[i�actrnr or Aotncowt�cr(for iunstallat�ions aalowed to bc pcx!'ormed by the�tomeowuer)mn-at 6e snbmitCed
with the pemut a�J�licat�on. A.��lic�txons sabmitted witl�out an F�V whaa s�ch�s r�qnired,w�not be
proce�ed fox Pen�ait L�.ciaance and will bc rernxned fox compl�Cion. •
� 3 1 /� l V►�1 V��UC(lnclucling labor aed materinla)� �)����vV Dat� �� s
Job Address � �
n� i f s !A'1 �en�vf�� Coatractor � -�. C Y�� �•�-�-_
� �
[]Sing�e Family nplex ❑1�'�ulti-Faimily �Reptal �Commcrcial IodastriAl
Number of Fixtures: � ,
9a�hlub Sump Pump Plastcr Sink Roof Drsin
ShnwcT San.3ump/PumP 3cullery Siak Sode Disp
��r�ro� VV81��{�a Service Sink Cnf�a Mkr
l.ava�ory
St,ndpipe Rce Shump Sink Sitc D�ain
Toilcl
Geragc FD 9urgcoaa Sirilc W�itr�Sm
�W� 5�1�� Ice Clx�
Kit Sink
. bisposn! ��S�
RPZ Valvc Comm 1Ce Mekcr
Brwlcrn+5'vJt Didet Int Gr�ase Trop
Diahwashrr Ext G�aso Trap
Classrm$ink Urinal
Floof Dnin Eye Was�+Stn
E:am Siede BcerTap °
Hosc 8ibb fkduu Mac
F Prcp S��k Dipper Well
Wacer Hcnccr W��x�pqu
U�3as 17 Elect 0 PwrVnl Floor 5ink Urink Fn►n
Clothca Wshr Nnod Sink ' . Waslt Enen . . . Wt�URaBe Mt�
l,�Cry Tray f.nb 5ink Cetch 6�4Q+ . „_� Misc Fixaues
Electric Con�tractor(for ProyecLc not requining e� �'IV Form)�
us��rrar�re o�wo,�-�lr►s���l '' r rar� -�� s�
.
Size Material Typc #. „ Conn.Type
Sonitary Sewor
Storm Se�wer :
Water Scrvicc
06/09