HomeMy WebLinkAbout0152031-Plumbing (bathroom remodel) I
� CITY OF OSHKOSH No 152031
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 926 N LARK ST Owner MARLENE M DREW Create Date 08/13/2012
Contractor AHERN-GROSS INC. Category 413-Res-Interior(Replacement Fixtures) Plan
Inspector Jerry Fabisch
Bathtub 1 Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Deduct Meters
Shower Lndry Tray Exam Sink Sterilizer Soda Disp Wtr Sewer Mtrs
Whirlpool Sump Pump F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory San Sump/Pump Flr/Wst Sink Bidet Site Drain Misc.
Toilet 1 Water Softner Hand Sink Urinal Wait.St. Fixtures
Kit Sink Standp Rec Lab Sink Beer Tap Ice Chest
Disposal Gar Drain Plaster Sink Dip Well Comm Ice Maker
Dishwasher Local Waste Sculry Sink Drink Ftn Int Grease Trap
Floor Drain Bar Sink Serv Sink Wash Ftn Ext Grease Trap
Hose Bibb Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn
Water Heater
Use/Nature FR/BATHROOM REMODEL '"'check#2116
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld#
1603150000
Valuation $1,100.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided I
Issued By ��� Date 08/29l2012
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 218 S MAIN ST FOND DU LAC WI 54935 -4908 Telephone Number 920-921-1414
To schedule inspections please cail the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Finai,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 �
Inspcction Services Uivisio�z
P O Box 1130
Oshkosh,WI 54903-1130
Phone:(920)236-SP50 Of HKO H
Fax: (920)236-5084
ON THE WATFR
Plumbin� Permit Application
1 hereby apply for a permit to do and install the following plumbing on the premises hereinafter described,the work to conform to thc
Wisconsin State I'lumbing Code, in thc perfonnancc of which all partics hcrcto agrcc to and arc bound hy said statutcs.
Job Address �6 Ia�k Sttroet VaIUC (Includinglaborand matcrials) �u�•� Date ���
Owner �'� �"' Contractor �S P�� #225314
OX Single Family ❑Duplex ❑Multi-Famiiy ❑Rental ❑Commercial ❑Industrial
Number of Fix4ires:
[3alhWb 1 Stcrilizcr _._-_-- 13rcakrmSink -__--_-
Whirlpool 1_ndry Standp ____ I)cnt.Oper. ___ tihamp Sink _
Lavatory llisposal ---_-- llip Wcll _ flr/Wst Sink --
Toilet 1 Dishwashcr Drink f�in Catch E3asin
Res.Sink Sump Pump Wait.St. ____ Wash Ftn _
Bar Sink Bjector/Grind icc Chcst Urinal
Water lieater Water Softncr Exam Sink _ Gar Drain
❑Gas ❑Electric Cl Power Vent �al Waste Sculry Sink Soc1a Disp
Shower Clothes Wshr Hand Sink Coffee Maker
Floor Drain Bidet F Prep Sink [ce Maker
[ndry Trry Bccr Tap _ Scrv Sink Site Drain
L.ab Sink Classrm Sink _ Int Grcasc Trap _ Roof[hain
Plastcr Sink Surgcons Sink ^_ Gxt Grcasc Trap Standp Rcc
Etectric Contractor OR ❑ EIV form attachec! (If Replacement)
Use/Nature of Work ��°ramdel'
Sizc Material Typc �l Conn.Typc
Sanitary Sewer
Storm Sewer
Water Service
• 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 pern�it fee,
which ever is greater. .
OR
Check here if you want this processed through your account ❑
PERMIT FEE $25.00