HomeMy WebLinkAbout0159036-Plumbing (laterals) � CITY OF OSHKOSH No 159036
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3746 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
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 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"
f
I
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 12/12/2013
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 OJI--�C��H :
QN THF WATFR
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
I�vou are a contractor participatin� in the Permit Fee Account Svstem and have adeguate funds. check here :
if vou want this processed through vour account ❑
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for instat�tions allowed to be perfarmed by the homeowner)mnst be snbmitted
with the permit application. Applications submitted without an EIV when such is reqnired, will not be ;
processed for Permit Issnance and will be retarned for completion.
���JOb Address ( � Y�v�'`��ValUB(Including labor and materials) Date �/! �, '�
Own G�.�'C6'1�//y l�/`�d Contractor �-���� f ��
ingle 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 Gazage FD Surgeons Sink Waitrs Sm
Kit Sink Local Waste Sterilizer Ice C}►est
Disposal Baz Sink RPZ Valve Comm Ice Maker
Dishwasher BreaFam Sink Bidet Int Grease Trap
Floor Drain Classrm Sink Urinal Ext Grease Trap '
Hose Bibb Exam Sink Beer Tap Eye Wash Sm
Water Heater F Prep Sink Dipper WeII Deduct Meter
u Gas C Elect G PwsVnt Floor Sink Drink Fnm Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fnm WV Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work���C�� �z�-������
Size Material Type # Conn.Type
Sanitary Sewer � /`�V �' ���'����
Storm Sewer N�V 2 2 2��3
Water Service / ��y�
s
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INSPECTi(%'�SERVLC£S Dl�"iS10'V
06/09