HomeMy WebLinkAbout0158935-Plumbing (laterals) � CITY OF OSHKOSH No 158935
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD '
ON THE WATER
Job Address 795 WEATHERSTONE DR Owner PAUL&SUSAN PENZENSTADLER Create Date 12/02/2013 '
Contractor ZILLGES EXCAVATING _ 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 Flr/Wst 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 Breakrtn Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature NSFR/exterior laterals for new house
of Work
�__ _�
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 New
Storm Sewer 6" Plastic Lateral 1 New
Water Service 1 1/4" Plastic Lateral 1 New
Parcel Id#
Valuation $1,500.00 Plan Approval _$0.00 Permit Fees _ $150.00 ❑ Permit Voided�i
Issued By �� Date 12/02/2013
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 cure any necessary approvals before starting such activity.
Signature _ � L��- Date �G 'z—� �
AgenUOwner
Address 1800 FOUNTAIN AVE OSHKOSH WI 54904 -1045 Telephone Number 231-1994 :
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 � �---�K�S�-.-�
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
If vou are a contractor participatin� in the Permit Fee Account System and have adeguate firnds check here
if vou want this pr•ocessed throuQh 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)mnst be submitted
with the permit application. Applications submitted without an EIV when such is reqnired, will not be
processed for Permit Issuance and will be returned for completion. :
-7p �
Job Address [ -L��«t:�t�S��l� Va�UC(Including laborand materials) j `�a�-� Date 12'Z-� �
Owy�r �r.n2can Stq�l e r' Contractor 'Z � ����� �����S�
[�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 Garage FD Surgeons Sink Waitrs Stn ,
Kit Sink Local 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 Stn
Water Heater F Prep Sink Dipper Well Deduct Meter .
C Gas 0 Elect�PwrVnt Floor Sink Drink Fntn Wtr Sewer MV
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___ �c,�,.�e�/'���-�E-t✓� � 5 �'�/`qy0„ .
Size Material Type # Conn.Type
Sanitary Sewer i-�j` �✓C.
�t, p��
Storm Sewer
Water Service 1 �/',��� 1F�►1
06/09