HomeMy WebLinkAbout0159141-Plumbing (shampoo sink) � CITY OF OSHKOSH No 159141
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 600 602 OREGON ST Owner RANGELOFF 922 OREGON STREET LLC Create Date 12/26/2013
Contractor D.R.HANSEN PLBG. Category 442-Commercial-Interior(New/Relocated Fixt� 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
Whirlpooi 0 Sump Pump _ 0 F Prep Sink 0 RPZ Vaive 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. � 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 1 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature OMM!instali beauty parlor sink
of Work
'debit acct**
Size Materiai Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0300120000
Valuation $600.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided'
Issued By ���i Date 12/26/2013
In the performance of this work, I agree to perform ali 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 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
anspection Scrviccs Division �
P O 8ox I 130 �
Oshkosh,WJ 549U3-1130
Phonc:(920)236-5050
Fax:(920)236-5084 �
ON THE W/UER
Piumbing Permit /�pplicafion
I hereby apply for a perm'rt to do and install the Followin�ptumbing cnn th�prcmises hcrcinaftcr dcscribed,the work to conform to the
Wisconsin State Plambing Code,in the perfaRnance of which aU parties hereto agree to snd are bound by said statutos.
• Applicadon(s)and fee(s)can bo brought to City H'aU,Roonn 205 or mailed to Inspcction Scrvices,PO Box 1128,Oshkosh WT
54903-1128. Commencing work withaut permit(s)will result in fees being doubled or$1 p(1.00 qlus the norm�l petmit fco,which
cvcr is greater.
OR
If vou are a contraclor narticinalinQ in the Permit Fee iJccounl Svstenr and have adeq,uate fi� ec�er•e
jf vou a�g,�l, h,�es�»roce�sed thror��h vonr Qccounl n
*'`Advisory�Far applicablc�rojccts,an Electzxcal Installation Ve,txf' tcat�iom(E�faiom,signed by t�e Electrical
ConRxactor or Homeowner(fvr installatioas allowcd to be pe.�onmcd by the homcownec)must be sabx�auit�ed
wxth t�e��inoonit a�bi�at�iom. A.ppuicat�ions sabno�itted withoat an EN whea sach is reqnfrcd,w�l not 6c
�nrocessed fmt Pwmirt�ssaance and w�71 be retanaed,for connpletion. � ,
,1ob.Address�6�� � r��►-D►� Valae�r��i�am8 i��,d,�,ao�a� � � Uate 1.�-- �.� � ;
(lwner � p n _�S[obSQ� Conbractor u � I �'(�_
�Sin�le�'am� [�Anplcx ❑Mniti-Family QRcntal �Comrnerdal �� atrial
Namber of�'ixtares: . :
Bolhtub Sump Pump Plaseer Smk Roof ihain
Showcr Snn.Samp/Pump St�dlay Shtk 5oda Uiep
Wliirlpnol Wptcr Soilencr Scrvice 3i++k Co1R'a Mkr
Lsvatory SranApipc Ra Shamp 5ink Sicc Drain
Toilcl Gnraqc FU 3urqc�ma Sink Wiihs Ctn
Kic Sink Locsl W�te Stpilimr Tca CI►�qt
- Di�xl Bar$ink RI'"/.vnlvc Comm lce Mnka
n��n� g�,smk ��a�c r,n�����n,P
Floot Drnun ______ Cl�srm Siek Urinal C�cl Gre�uc T►ap
liose Bibb G�rnn+Sink Reer Top Fyc Wosh S�.n
Wntcr Flrntcr P Prcp 3ialc ni},per wdl neQuct Mctcr
❑Gea f7 Elcct Cl PwrVrrt Floqr 3ink Drink Fntri Wtr 3cwcr Mtr
Clothct Wslv FinnA Sink ' , Wa.ch Bn6n •, VVIr Usa�Mk
Indry Tr�y I�b Sink Cntch Aaain . MisC Cixlurcs
Electric Co�ntractor(for projects not reqairing an N Form)
�
Use/l�tatare of Work �h5 �1) � � c/ v✓ '
Si�e Materis 'I�pe �t., _ Conn.Typc ,-
Sanitary Sewer
Sturm Scwer '
Watcr Scivicc
O6/09