HomeMy WebLinkAbout0159038-Plumbing (laterals) � CITY OF OSHKOSH No 159038
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3750 GLENKIRK LN Owner WINNEBAGO DEALER INVENTORY Create Date 07/19/2013
Contractor ABSOLUTE PLUMBING OF WISCONSIN 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
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 FldWst 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 0 Eye Wash Statn 0
Water Heater 0
Use/Nature New Mobile Home/Install sewer and water laterals
of Work
�"'ck#2860'*
�
Size Material Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 New
Storm Sewer
Water Service 1" Plastic Lateral 1 New
Parcel Id#
1278400000
Valuation $500.00 Plan Approval $0.00 Permit Fees $100.00 ❑ Permit Voided'� '
Issued By ��/�- Date 12l12/2013
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 N1473 ELLEN LANE GREENVILLE WI 54942 -9602 Telephone Number 920-757-7222
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 os�((� ru
I i\`.JJ 1 I
QN THE tVA7ER
Plumbing Permit Application
I hereby a�ly for a permit to do and'mstall the following ptumbing on the premises hereinafter described,the work to conform to the
Wisconsin State Plumbing Code,in the performance of which all parties heret�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 wi�out permit(s)will result in fees being doubled or 5100.00 plus the normal permit fee,which
ever is greater.
OR
f vou are a contractor narticinatinQ in the Permit Fee Account Svstem and have adeguate funds check here
if vou want this processed throu�vour account n
. **Advisory-For applicable projects,an Electrical Instailation Verification(EI�form,signed by the Electrical
Contractor or Homeowner(for installations allowed to be peiformed by the homeowner)mnst be snbmitted
with the permit application. Applications snbmitted withont an EIV when snch is reqnQed, will not be :
processed for Permit Issaance and will be retamed for rnmpletion.
Job Address 7�G'�����'�� Value(�a�a�g�seor�a�s� Date`�/ ���
�� �����N/���� Contractor ����U� ����
ingle Family QDnplea �Malti-Family �Rental �Commercial �Industrial
Nnmber of Fiatures:
Bathtub Sump Pump Pl�ter Sink Roof Drain
Shower San.Sump/Pnmp Scuilery Sink Soda Disp
Whirlpool Water Softener Service Sink �ff��
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sinl� Waitrs gtn
Kit Sink l.ocal Waste Sterilizer Ice Chest
Disposai Bar Sink RPZ Vatve Comm Ice Maker
��,� Brealam Sink Bidet Lit Grease Trap
Floor Dre� Classrm Sink Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Stn
Water Heater F Prep Sink Dipper Wetl Deduct Meter
❑Gas�Eled�Pw+rVnt Floor Sink Drink Fntn Wtr Sewer Mtr
C��W� Hand Sink Wash F�n Wtr Usage Mtr
Lndry TtaY Lab Sink Catch B�in Misc F'vct�es :
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work��/1��� ���C��z��'—����i \
Size Material Type # Conn.Type
Sanitary Sewer � /��" �.�����.��
Storm Sewer
water Service ! �Q�� N 0 V 2 2 2013
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