HomeMy WebLinkAbout0101901-Plumbing CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
No 101901
OSHKOSH
ON THE WATER
Job Address 855 N WESTHAVEN DR Owner AURORA MEDICAL CENTER OF OSHKOSH IN Create Date
Contractor J.F. AHERN CO Category 440- Industrial-Interior
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain
Whirlpool 0 Floor Drain 12 Water Softner 1 Drink Ftn 0 Serv Sink 0 Soda Disp
Lavatory 8 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker
Toilet 4 Lndry Stndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 7 Int Grease Trap
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 13 Catch Basin 0 Ext Grease Trap
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 2 Classrm Sink 0 Lab Sink 7 Plaster Sink 0 Standp Rec 0
Roof Drain 2 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 3
06/02/2003
Plan
Use/Nature COMM/Hospital plumbing work (fixtures listed above & 15 reduced zone backflow preventers).
of Work
Valuation
Issued By
Size Material Type # Conn. Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
$170,000.00 Plan Approval $0.00 Permit Fees $450.00
Date
06/03/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 855 MORRIS ST PO BOX 1316 FOND DU LAC WI 54936 - 1316 Telephone Number
921-9040 EXT 339
Plumbing Permit Application Page 1 of 2
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
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 brou~at 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 not~nai permit fee, which ewer is greater.
OR
If you are a contractor participatinq in the Permit Fee Account System and have
(Including labor I$170,000 Date]5/29/03
Address and materials)
Owner ]Au[ora Contractor I~ [: ~erP~. ' 'i /" '"'
Use Category:
C Single Family
C Industrial
C Duplex C Multi-Family C Rental
Commercial
Number of Fixtures:
Bathtub I Lndry Standp I Dent. Oper.
Whirlpool [ Disposal ] Dip Well
Lavato~ [8 Dishwasher ] Drink F~
Toilet ~ SumpPumpl Wait. St.
Res. Sink [ Ejector/Grind [ Ice Chest
Bar Sink i Water j
Softener Exam Sink
Water Heater F
(~ Gas (~ Electric Local Waste ] C PwrVnt
Shower] Clothes Wshr ]
Shamp Sink ]
Flr/Wst Sink
Catch Basil:
Wash Ftn
Urinal
Sculry Sink I ; Soda Visp [ ·
Hand Sink I Coffee Maker [
~,oorDra,~ l!2 ~,det I FPrepSinkl IceMaker [~
Laundry Tray [ Beer Tap ] S~vS~nkI Sit~an [2
Int Grease I~
Lab Sink 1~ Classrm Sink ] Trap] Roof Drain
Reduced Zone Backflow Preventers - 15
http://www.ci.oshkosh.wi.us/community_development/permit_app~lumbing_2002.htm 5/29/03
Plumbing Permit Application Page 2 of 2
Surgeons Ext Grease Standp Rec I .........
Plaster Sink [ S nk Trap
Sterilizer [ Breakrm Sink [
Electric Contractor
Permits requiring an Electric Installation Verification form can not be processed by e-mail since both
the application and EIV form must be submitted together. You may print these forms and submit them
together by coming to our office, mailing them or faxing them together at 236-5084.
Use / Nature of Work~tg?~!~l ;
S~e Material Type # Conn. Type
Sanitary Sewer I [ [ [ ~
Storm Sewer I ii I [ I
Water Service ] iii11 '[ [ ]
http ://www.ci.o shkosh.wi.us/community_development/p ermit_app_plumbing_2002 .htm 5/29/03
F. Ahern Co.
Full Service Mechanical and Fire Protection Contractors
855 Moms St., RO. Box 1316. Fond du Lac, WI 54936-1316
TEL (920) 921-9020 · FAX {920) 921-8632
www.jfahern.com
TO:
COPIES
1
1
CITY OF OSHKOSH INSPECTION SER\
PO BOX 1128
OSHKOSH WI 54903--112
SPEC SECTION/D~VG NO DESCRIPTION
Plumb/ng Permit Application
Check # 1779 in the amount of $450.00
TRANSMITTAL
DATE: 5/29/2003
PROJECT: 223044
AURORA MEDICAL
RE: PLUMBING PERMIT APPLICATION
STATUS
FOR APPROVAL
FORYOURUSE
Notes:
J. F. AHERN CO.
ENCLOSURE
/mkg
CC:
JOHN G. KLINZING
PROJECT MANAGER
PLUMBING DEPARTMENT
$995