HomeMy WebLinkAbout0159023-Plumbing (interior remodel) /�"� CITY OF OSHKOSH No 159023
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 316 COURT ST Owner CRESCENT MOON PROPERTIES Create Date 12/10/2013
Contractor E C MERRILL INC Category 410-Residentiai-Interior Plan
Inspector Jon Mueller
Bathtub 1 Clothes Wshr 1 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 2 Lndry Tray 0 Exam Sink 0 Sterilizer 0 Soda Disp 0 Wtr Sewer Mtrs 0
WhiMpool 0 Sump Pump 0 F Prep Sink 0 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 4 San Sump/Pump 0 FldWst Sink 1 Bidet 0 Site Drain 0 Misc. 0
Toilet 3 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. 0 Fixtures
Kit Sink 1 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 1 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/Remodel plumbing
of Work
I
'Paid with check
�
Size Material Type # Conn.Type .
Sanitary Sewer
Storm Sewer '
Water Service
Parcel Id#
0201060000
Valuation $8,000.00 Plan Approval $0.00 Permit Fees $126.00 ❑ Permit Voided
issued By �S Date 12/10/2013
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 809 WISCONSIN AVE N FOND DU LAC WI 54937 -2702 Telephone Number (920)921-4714
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 Oshko_n
Inspection Ser�ices D:�i�i�:
P 0 Box 1130
Oshkosh, �l"I ��9u ' �=:
Phone: (920� � 5-��:�) �/ �f
� Fax: (920j ?�6 ::�c- ���IV��I I
O� -:-+E �:VAT�R
Plumbing Permit Application
I hereb� appl� f�- a rer^;it to dc and i^^sta:; t;e iollo«inQ plumbinQ on the premises hereinafter described, the work to conform to the
���i;cer,s:r. �:ate Plumbin� Code, in.he pzrformance of which all parties hereto aQrze to and are bound by said statutes.
� Application�s i and fee(s)can be brought to City Hall, Room 20� or mailed to Inspection Services, PO Box 1 128, Oshkosh �L'I ,
5�903-I 128. Commencing work without permit(s) will result in fees beinJ doubled or$100.00 plus the nonr�al permit fee, which
ever is greater.
OR
If vou are a contractor partrcipating in the Permit Fee Account Svstem and have adeqzrate funds, check here
if vou want this processed 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 submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
Job Address � �� C DU�Z � � 1 VaIUC (Including labor and materials) Or�QV Date i 2 1 �"' ( �
Owner t �`'/ �� ���' �� �Z Contractor � , C-• � � TZ� � � �- /��,
� �
�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial Industrial
Number of Fixtures:
Bathtub � � Disposal Drink Ftn Catch Basin
Whirlpool Dishwasher ( Wait.St. Wash Ftn ��
Lavatory � Sump Pump Ice Chest Urinal '
Toilet EjectodGrind Exam Sink Gar Drain `
Res.Sink �� Water Softner Sculry Sink Soda Disp
Bar Sink Local Waste Hand Sink Coffee Maker
VVater Heater Clothes Wshr �_ F Prep Sink Comm.Ice Maker
=Gas-Elect C PwrVnt Bidet Serv Sink Site Drain
Shower Z ' Beer Tap Int Grease Trap Roof Drain
Floor Drain Classrm Sink Ext Grease Trap Standp Rec
Lndry Tray Surgeons Sink R.P.Z.Valve Eye Wash Stn
Lab Sink Breakrm Sink Shamp Sink Wtr Sewer Mtrs
Plaster Sink Dip Well Flr/Wst Sink � Deduct Meters
Sterilizer Hose Bibs Wtr L'sage Mtrs
Misc.
Fixtures �' `
Electric Contractor (for projects not requiring an EIV Form)
Use/Nature of Work �� tl�����i L �- V�� �I►V Ej
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer `� �/� �� p v
Water Service ��� �
o�/o�