HomeMy WebLinkAbout0159171-Plumbing (new water service)**VOID** �
� CITY OF OSHKOSH No 159171
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD E
. ON THE WATER
Job Address 680 W 5TH AVE Owner EXCEL PROPERTIES LLC Create Date 12/30/2013
Contractor WALTER R SCHMID JR _ Category 401 -Residential-Exterior(laterals) Plan
Inspector Jerry Fabisch
, 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 FldWst 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 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\New water service
of Work
�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
;::
Water Service 1" Plastic Lateral 1 New
Parcel Id#
0603360000
Valuation $1,100.00 Plan Approval __$0.00 Permit Fees $50.00 ❑ Permit Voided'
Issued By Date 12/30/2013
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 easem t,the City stron I urges the permit applicant to contact the
easement hol r( ) d to e re ar�ce ary a rovals befor st ing such activity.
Signature Date l � ^�/U"—� �
AgenUOwner
Address 7821 SWISS RD Oshkosh WI 54902 -0000 Telephone Number 688-2496
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.
i
. {
City of Oshkosh
Inspection Services Division �
P O Box 1130 �
Oshkosh,WI54903-1130
Phone: (920)236-5050
Fax:(920)236-5084 ���--�K���--�
. ON THE WATER '
Plumbing Permit Application
I hereby apply for a permit to do and install the following ptumbing 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 Account Svstem and have adequate funds check here
if vou want this processed throu�vour account n
**Advisory-For applicable projects, an Electrical Installallon 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 Issnance and will be returned for completion.
Job Address 1pp Q �/�/ ��� ��� VaIUC (Including labor and materials) � �O � ` Date �� �� d �-I
Owner �C�/�w�� �Gh�'Vl�tt��4/ Contractor _
❑Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑I dustrial
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 0 Elect�PwrVnt Floor Sink Drink Fntn Wtr Sewer Mv
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fiatures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work �'yv S��C Cr �i(�� 7`L IZ oC 1}1/�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service � /' �� ��l � G��-
s Y
06/09