HomeMy WebLinkAbout0159156-Plumbing (RP valve) � CITY OF OSHKOSH No 159156
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1228 W SOUTH PARK AVE Owner OPT PROPERTIES LLC Create Date 12/26/2013
Contractor KASCADE PLUMBING L.L.C. _ 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
Whiripool _ 0 Sump Pump 0 F Prep Sink 0 RP2 Valve 1 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. 0 .
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 Weil 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 COMM/install RP valve per Hydro survey results
of Work
i*"DOUBLE FEE FOR WORK WITHOUT PERMIT"
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1307260000
Valuation $10,000.00 Plan Approva $0.00 Permit Fees __ $130.00 ❑ Permit VoidedJ
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)an ecure any necessary approvals before starting such activity.
Signature �y ��_� Date /�,f -aE� � �
�
AgenUOwner
Address 7265 COUNTY RD D OMRO WI 54963 -9333 Telephone Number (920)582-7304
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,WI54903-1130
Phone:(920)236-5050
F�:�9za,z,6-sa84 OlHKO.IH �
ON THE 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 confarm 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 norma(permit fee,which
ever is greater.
OR
If vou are a contractor participatinQ in the Permit Fee Aecount Svstem and have adeguate fitnds check here
if vou want this pr�ocessed through 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 snbmitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion.
Job Address/�,18�9��c.-��h �� �� Va�UC(Including labor and materiats) Date j �� -� fi' /�,�
Owner �� o s /"��, � i� Contractor �}C«��� �f��
❑Single Family ❑Duplex ❑ ulti-Family ❑Rental pCommercial ❑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 Garage FD Surgeons Sink Waitrs Stn
Kit Sink Local 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�Elec[C PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fnfi Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fiatures
Etectric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09