HomeMy WebLinkAbout0159140-Plumbing (repair sanitary sewer) � CITY OF OSHKOSH No 159140
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 411 W 10TH AVE Owner MARK W/JANET A VENUS Create Date 12/26/2013
Contractor D.R.HANSEN PLBG. 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 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. p
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. p 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 SFR/repair 6"sanitary sewer 1 ;
of Work
'debit acct"
i
Size Material Type # Conn.Type
Sanitary Sewer 6" Plastic Lateral 1 Repaii
Stortn Sewer
Water Service
Parcel Id�
0906410000
Valuation $1,000.00 Plan Approval __ $0.00 Permit Fees $50.00 ❑ Permit Voided'
Issued By �� Date 12/26/2013
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 55 KNAPP ST OSHKOSH WI 54902 -3448 Telephone Number 233-1595
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 specifed 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
ir�pection Scrviccs Division �
T O Box I 130 �
Oshkosh,WJ 54903-1130
Phono:(920)236-SOSp � � �
Pax;(920)236-5084
UN TNB W/�TER
Plumbing Permit �pplication
I hereby apply fnr a petmit to do and instal]the fallowing plumbirtg on ihe prcmises herciaaftcr described,the wc>rk to conform to thc
Wisconsin State Plumbing Code,in the performance of which all partics h�rcM agrex to and stre bound by said statutos.
� Application(s)and fee(s)can be broaglrt to City Hall,Room 205 or mailed to Inspeetion Service.c,PO Box 1 i 28,Oshkosh WI
54903-1128. Commencing work without pernnit(s)will r�ult in fecs bcing doubled or$100.00 pins the normal permit fee,which
ever iF greatcr.
OR
�pp are a contrac[or n,gr{icipatin� in !he Per,�ii Fee dccount S r��om Qpd have adeauale fund;�. cf�eck hare
it vou wanl this_nr���,esed ihror�Ph vout q unt
'b*Advisory-Fvr appUcabae p�ojects,an Elect�ica�l�mstalla�ion Va�i&catiou.(E�fnrin,agned by dt�e E1ec�,ica1
Con�acCor�t Hoitnieo�vt�cr(�ar iastallatirnas aUowed to bc perfa�ued by tfie hmneowner)must be snbanitt.�cd
witb►�tbie pe�mit appIication. Appbic.arion4 sabmitted wiRhout an E�Y wbcn snch is x�equiared,w�71 not be
prucessed fox�ermit Isaoance�w be tctmncd for co�oo�pl�bion. � .
r� � �0 0 v �U U Da te � �'� ��
Jo b A d dr�ss �.J V � VA IU@(haluAin�laber Ra �.ie
Owt�er -eY111 Contractor Vn'1 rl' �C.
�Single F mily �Dnplex �Multi-Family ❑�tental . ❑Commercial dastrial
Na�ber o#k'ixtarc.�: �
Battilub Sump Pump �'It�tcr sink Rnofiham
$howcr $an,9um1�/Pnmp 5cullcry Sink Sode Disp
Whirlpcu�l Wita Snftcncr , 9crvicc 5irek CoF1ac Mkr
�.cw�cory �, 3tattdp+pc Rce 9hamp Sirdc Sitc D►sin
Toilet Onrnqc FD Surgcons Sink Wnitrs Sln
Kit Sink Local Wante SIcrlNzer TeC ChCSI
- Dir+porraal HerSink RPZ Valvc Comm kc Mckcr ___,
Dlshwasl+er [��eakrm Sink Aidcl fn[(ircf�.ac'hap ,
Flnnr Drsm Clmeq.mi Si�c Urinal Fact Crtease Trnp
Haac Bibb Fxam Sirdc [ixrT� Eyc Wash Str�
Wet�Hcnta F Prep Sink Ulpper WCII DcdpU MCICr
U(},s Ij FJcct�PvurVnt rloor Sink Drink Fnln VVtr 5cWra Mv
CMtlx�,Wshr F1and Sink ' . Wt�.sh Enpn ', • Wlr Ll,c�c Mtr
��Y�r�Y Lab Sink Calrh i3yccr Mise Fix�urea
Electric Contr�cEor(�o�p ,jects notrcguiwing an EIV Form)
/-�� 1
Usc/Nature o�Work Q � �
� r b � �-'1�X
Si�e Materisl T e #_ _ Conn.Typc ;-
Sanitary Scwcr
Slx�rm Sewer
Water Servicc
06/09