HomeMy WebLinkAbout0158860-Plumbing /�'� CITY OF OSHKOSH No 158860
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER :
Job Address 965 967 ALPINE CT Owner JEFFREY M/DIANE GROFF Create Date 11/18/2013
Contractor REBATH OF CENTRAL WISCONSIN Category 413-Res-Interior(Replacement Fixtures) Plan
Inspector Jon Mueller
Bathtub 1 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 FIr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 1 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. Q 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 DUPLEX/remove exising fiberglass tub and install new one !
of Work 1
"debit accY'"
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel id#
1525380000
Valuation $400.00 Plan Approval ___ $0.00 Permit Fees $30.00 ❑ Permit Voided I
Issued By ,� Date 11/2U2013
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address 230 N KOELLER ST OSHKOSH WI 54902 -4104 Telephone Number (920)765-0068
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
Nov 18 2013 10: 32AM: . . REBATH CENTRAL WI 9203035935 : :. No 4170�: P� 2/2�f---� , � ; ;
- r ..��
' ; . . ' .. . . ON TNE WATER
. . :
PlurnbiRg P. e�mit �ppl6cafror� .
. .. I hereliy apply for a permit�o.do and install,the followiAg plumbing on'the premises hereinafter dcscribed,the.work#o conf�rm�CO the �
, , :Wisconsin State p)umbing Code;�the�eifonnance of which all parties hereto agree to and are bound by's,aid statutes:
� � Applicarion(sj and fee(s)can be brought to Ciby Hall,Room 205 or inailed to
5�903-112E. Coimmr:nciag Work without permit(s)wili result in fees being dou�bledcor�]p0.00 p us thBriorrn]pe���eC Which.
ever is greater, . ,
� . . . aR � .. . ,
. I ou are a c nlractar arlicl atin in the Permit Fee Accoun! S�.ctem and l�ave ode uare unds che.ck h�re
i vou wa�it this prnces.red thror�gh vour.accourrr
*'�Ad�visorp-�`or a�plicable proJects, an ElectnicaI Inst�a�Ia.�ion�Teiificat�on
Coz�ix2ctoz or$omeo�vvner(foz installa.tions aiiawcd to be perfoxmed by Lhe hom oR•�r)����Ye Sii�bmitt�c�
�avith�e perr�zir apglicario�. 14.pp�icatioas submit�ed w�tho�.t an EI�w�►en suct�is re�,ired, will ztot b� ed '
processed€or Periz�it�ssBanr�a�d��X be retuaied�or coFnpleEion.
Job A.ddress j� �'��U� � .
�Va.I1��(Including labor and maiorials) Q�• D�U ���e ,—��/..13
Owner � -� a Contra'c�or���orYrAS �j�u,}�q�s ��} �,.
❑Single Famil� �uplcx �]Mujti-�amf ❑Comtnercial ^��
�Y �Reutal
�Tndustrial
Number of Fixtures:
BaThlub �r Sump Piunp _.` F'lssrer Sink
Shower . Roof brain
S�SumP/!'umP. Scullcry Sink ,'�—
t�niripo�i Soda:Disp
Wexr Sott�aer Service Sink . ~�
CoIiec ivi�r
l,avatory Stsndpipe Itcc . Sh�np Sink .
�� Site Drain
• Toilet . Gerage Fl� Seir�cons Sink, Wai[rs Stn
Kit Smk Loca!W�re • :
Sterili�er' � Tce Chcst �
D�s?°sai, �ar Smk .
RPZ Vulve Comm Ice Maker�
Aishwasher Brealum Sink. "Bidei. . Int Grrasa 2}ap
Floor Dra9n Class�m Smkk Urinrl F.�d.Grease Trap
tiose Bibb Exam SiNc Beer T'sp . Eye Wash Sm .
Wsrc✓Hemv . F Prep Siak Dipper well
�0 C3ae 0 blect q.PwrVnt Deduct Metcr
...... .
Floor Siolc Drink�nv� Wtr 5ewer Mv ,—
. . _Clothes Wshr ' Hand,5ink_.: •
... ..
. . . _ ... .._Wush_fn� . .... _. „
....._(-►��J.Y.:ir?Y_.__... ._._I,abSink - -._.. . WtrUs,�eMv_
_. . .. __CaIc6 8asin.--- -• .`
......._. .... ....
• --..•–• ' .._....:. ..1vlis�Flxtu[es
.__.._ .... ... .. .. . ..
�leciric Coadx�ctor�(faz�pr�jeets no�req�i�r�g�.n��V�orm) . . - .. . ..
. . ...., : .. .__..
.. . _.. ...... . . . . .
__ ..._....__.. _...
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TJse I l�atirre Q��VQxk � . ....,._ ... . . . ...... .. ... .,. .. .. . „ ... .
. . . � Size Mate�� . ;r�� TM .
. .............. r ..
Conn: Type
. .... . •
Sanitary-Sewer .. . .. .. .. .. . .... ._.. .. . ... . ... . _...
. . . . �.. .. .,_._.. �- .. . ...
. . � - - . . � . � .
5tarm Sewer
Water Service • •
.. . � .... . . . .
. :.,,. . ....
;: .
... 0.6/09
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