HomeMy WebLinkAbout0104386-Plumbing (storm lateral)OSHKOSH
ON THE WATER
,Job Address 2375 ALLERTON DR
Contractor MERTEN PLUMBING
CiTY OF OSHKOSH No 104386
PLUMBING PERMIT - APPLICATION AND RECORD
Owner DOUGLAS A/DANAWHITELEY JR Create Date 09/24/2003
Category 401 - Residential-Exterior (laterals) Plan
Bathtub 0 Shower
Whirlpool 0 Floor Drain
Lavatory 0 Lndry Tray
Toilet 0 Lndry Stndp
Res. Sink 0 Disposal
Bar Sink 0 Dishwasher
Water Heater 0 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
0 WaterSoftner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0 tnt Grease Trap 0
0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
0 Beer Tap 0 SculrySink 0 Wash Ftn 0 RPZValve 0
0 Dent. Oper. 0 Hand Sink 0 Urinal 0 Eye WashStatn 0
0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature Storm Sewer
of Work
Valuation
Issued By.~~
Sanitary Sewer
Size Material Type #
Storm Sewer 4" Plastic Lateral
Water Service
Conn. Type
0
0
0
0
0
1 New
0
0
0
0
0
0
0
0
0
$2,000.00 Plan Approval $0.00 Permit Fees $25.00 [] Permit Voided
Date 09~24~2003
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.
Date
Signature
/ ~' ~' · ' ~'~ Agent/Owner
Address 1087 COZY LANE OSHKOSH WI 54901 - 0000 Telephone Number
231-6795
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
POBox t130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O_/HKO._/H
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter descr/bed, 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
lf vou are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through Four account ~
Job Address ~7~ .,~/~r/~,,, ~),r Value (Ineludinglaloorandmaterials) ~E.~c',~
Owner X~o~tD tb_;h the Il/ Contractor ,qq~/q~,,/g&~ b ;,,~
fi~]Single Family [--IDnplex [~]Mnlti-Family [-]Rental [--1Commercial
[--]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Fte Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Sofmer Exam Sink Gar Drain
Water Healer Local Waste Sculry Sink Soda D/sp
[3 Gas 12 Elect [2 pwrVnt Clothes Wshr Hand Sink Cot'tEe Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Iht Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Staodp Rec
Plaster Sink Breakrm Sink R.P.Z. Valve Eye Wash Sm
Sterilizer
Electric Contractor
Use / Nature of Work
OR
[-~Electric Installation Verification form attached
(If Replacement)
Size Material Type # Corm. Type]
Sanitary
Server
Water Service
7/03