HomeMy WebLinkAbout0158856-Plumbing (install sewer & water) � CITY OF OSHKOSH No �sssss
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3020 OREGON ST Owner LORENZ UKAREN S RANGELOFF Create Date 11/19/2013
Contractor KURT ZENTNER&SONS INC_ Category 401 -Residential-Exterior(laterals) Plan
Inspector 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 FINWst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 0 Water Softner 0 Hand Sink 0 Urinai 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 Weli 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/install sewer and water laterals :
of Work
"debit acct**
*"WAITING FOR FUNDS"' �
I
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 New
Storm Sewer
Water Service 1" Plastic Lateral 1 New
Parcel Id#
1413310600
Valuation $600.00 Plan Approval $0.00 Permit Fees $100.00 ❑ Permit Voided '
Issued By � - Date 11/21/2013
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address 2860 OREGON ST OSHKOSH WI 54902 -7136 Telephone Number 235-1340
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not perFormed within two business days from the time the project is ready. .
City of Oshkosh �
Inspcction Services bivision
P 0 Box 1130 �
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax:(920)236-5084 HKOfH
pf.iNE 1�nTFR
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described,the work to conform to the
Wisconsin State Plumbing Code,in the performan�e of which all parties hereto agrcc to and are bound by said statutes.
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Scrvic�s,PO$ox 1128,Oshkosh Wl
54903-1128, Commencing work without permit(s)will result in fees being daubled oc$100.00 plus the normal permit fee,which
ever is greater.
OR
! ou are a contrac�or ar � i atin in the Permfl Fe Account S stem and have ade uate und check here
i ou wanl this rocess d tl�rou h our account
**Advisory-For applieable pmjeets, an Electrieal Ynsta.IIation Veiification(EI�form, signed by the Electrical
Contzactox or Homeowner(for installatiouis atlowed to be peiformed by the homeowner)mmst be snbmitted
with the permit application. A�p�ications snbmitted withont an EIV when sntb�is xeqn�ed,wiYt not be
processed for Per�a�it Issnaace and w�l be tetur�ued for completion.
,�ob Address CSf~�V1�Ile(Jncluding labor and materials) �G�. � Date h'' /
Owner �.o�rr��n S � COntracto�- Z � �
�ingle k'amily ❑Duplex OlV.[ulti-�'amily ❑Rental ❑Commercial ❑Industrial
Number of Fixtures:
Ba�htub Sump Pump Plastar Sink Roof brain
Shower Sen.Sump/PUmp Scullery Sink Soda Disp
Whirlpool Wate�$oftmner Service Sink Coffee Mkr
Lavatory Standpipe kec Shnmp Sink Sice Drain
Toilet Galage FD 5iageons Sink Wai4s Stn
Kic Sink Local Wasce Sterili2er Ice Cnes�
p�ypp� g�g�k RPZ Valve Comm Ice Maker
Dishwasher 8r��S�� Bidet In[GreBSe Trap
Floor Dtain Clasw-m Sink C7riaal EM Grease Trep
Hose Bibb �xnm Sink Beer Tap Eyc Wash Sm
water Hea[er F Pt'ep S� Dippcz well Deduc[Meter
0 Gas❑Elect�Pwrvnc �'loor Sink Drink Fntn WL'Sewer Mtr
Clothes Wshr Hend Sink Wash Fntn W7 Usage Mtr
Lndry Tray I,ab Sink Cn�ch Basin Misc Fixnues
Electric Contractor(for projects not reqairing an EY'V Form)
Y7se/Natare of Work �rlS.fs �1 S-e-�✓�/!r� �— �s.��s
Size Material Type # Conn.Type
Sanitary Sewer '�f� /'�vt� s L�' Y� �v'�
Storm Sewer
Wazer Service / �� �a / ��� ,�. �/1��s�
06/09