HomeMy WebLinkAbout0159150-Plumbing � CITY OF OSHKOSH No 159150
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1545 MARICOPA DR Owner GREGORY J/LISA L MCLAUGHLIN Create Date 12/26/2013
Contractor VALENTINE READER PLUMBING INC _ Category 412-Res-Interior(New/Relocated Fixtures) Plan
Inspector Jon Mueller
Bathtub 1 Ciothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 1 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 3 San Sump/Pump 0 FINWst Sink 0 Bidet 0 Site Drain 0 Misc. p
Toilet 2 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. � Fixtures
Kit Sink 0 Standp Rec
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/bathroom remodel - �
of Work
ck#12214"*
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Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1319330000
Valuation $5,600.00 Plan Approval $0.00 Permit Fees $63.00 ❑ 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 W2015 INDUSTRIAL DRIVE FREEDOM WI 54130 -7517 Telephone Number 920-788-2494
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 Box1130 �
Oshkosh,WI54903-1130
Phone:(920)236-5050
Fax:(920)236-5084 Of HKO.IH
ON 7HE 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 participatinQ in the Permit Fee .9ccount Svstem and have adequate fa�nds, check here
if vou N�ant this processed throu�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 snbmitted
with the permit application. Applications sabmitted without an EIV when such is required, will not be
processed for Permit Issnance and will be returned for completion.
Job Address 1��CJ �����-?���L�r• Va�Ue(Including labor and materials) ����� Date ��I'v%��`3
Owner I,...i s��� Gr��- 1'Y`�.�c�:�1}�'�Contractor //�o�/ ���°P_�,�i,�;�+ j�I�+,T�
�Single Family ❑Duplex Multi-Family �ental ❑Commercial ❑Industrial
Number of Fixtures: DEC 2 6 2013
Bathtub � Sump Pump ___.._ Plaster Sink Ro�f Drain
Shower San.Sum /Pum Sculle Sink P ��q�e 1� � �T^
� P P �Y �4�?1�Wf��3* +t�'b;,fiP\1FY'D'
Whirlpool Water Softener Service Sink T;��"�f�:�`�f::''�ir'FS Di\'{SIQV
Lavatory � Standpipe Rec Shamp Sink Site Drain
Toilet •, Crarage FD Surgeons Sink Waitrs Stn
Kit Sink Loca1 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
=Gas 0 Elect�PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fiactures
Electric Contractor(for projects not requiring an EIV Form) �� � ��O`3' �
Use/Nature of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09