HomeMy WebLinkAbout0104416-Plumbing (remodel)OSHKOSH
ON THE WATER
JobAddress 15 W 11TH AVE
Contractor SOPER PLUMBING
CITY OF OSHKOSH No 104416
PLUMBING PERMIT - APPLICATION AND RECORD
Owner KELLY J BURNETT Create Date 09/26/2003
Category 410 ~ Residential-Interior Plan
Bathtub I Shower
Whirlpool 0 Floor Drain
Lavatory I Lndry Tray
Toilet 1 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 DipWell 0 F Prep Sink 0 Gar Drain 0
0 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
I LocalWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
0 Clothes Wshr 1 Ice Chest 0 FIr/Wst Sink 0 lnt 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 Wash Statn 0
0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature
of Work
bUPLEX/ Replacement/RemodeL
Sanitary Sewer
Storm Sewer
Water Service
Size
Material Type #
Conn. Type
0
0
0
0
0
0
0
Valuation $2,700.00 Plan Approval $0.00 Permit Fees $30.00 [] Permit Voided
Issued By ~
Date 09/26/2003
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 1~'8er(s) a~o secure any~essary approvals before starting such activity.
Signature/~ ~-~.~~~ Date
/ ~'J ~/ ~ Agent/Owner
Address 2225 BURNWOOD DR Oshkosh WI 54902 - 0000 Telephone Number
426-2151
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, WI 54903-I 130
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 described, the work to conform to the
Wisconsin State Plumbing Code, in the performance of which ail 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-I 128. Commencing work without permit(s) ~vill result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
lf ¥ou 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 /:a'"' tto'.//~'~ Av~". Value (lncluding labor and materials) ~. P~'.~:>O Date ~--~'~,-~.~
Owner t~,.,~,,~'~-"~ Contractor ,~.--~ .~,~.~
[--]Single Family [~)uplex r-]Multi-Family [--]Rental [--]Commercial [~Industrial
Number of Fixtures:
Bathtub / Lndry Standp Dent. Opor. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatoly / Dishwasher Drink Fm Catch Basin
Toilet ~t Sump Pump Wait. St. Wash Fin
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Disp
13 Gas [3 Elect [3 PwrVnt Clothes Wshr // Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray f Classrm Sink Int Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Ree
Plaster Sink Breakrm Sink ILP.Z. Valve Eye Wash Stn
Sterilizer
Electric Contractor
Use / Nature of Work
OR [~]Electric Installation Verification form attached
j (If Replacement)
Size
Material Type # Corm. Type
Sanitary Sewer
Storm Sewer
Water Service
7/03