HomeMy WebLinkAbout0106040-Plumbing (water heater)OSHKOSH
ON THE WATER
.lob Address 141 HIGH AVE
Contractor J RASMUSSEN PLUMBING INC
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner KLRR INC
Category 411 - Residential-Water Heaters
No 106040
Create Date 01/13/2004
Plan
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 0 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 Lndry Stndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0 RPZValve 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature MULTI-FAMILY/RENTAL/#AA/ Replace electric water heater. * EIV form from Drexler Electric.
of Work
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Valuation $450.00 Plan Approval $0.00 Permit Fees $20.00 ~ Permit Voided
Issued By
Date
01/13/2004
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
Agent/Owner
Address 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 0000 Telephone Number
920-233-6747
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.
el/14/2004 e7:24
2335747
J RASMUSSEN
PAGE el/02
"
.
(f)
OJl"1KOJI-1
ON THf' \M"rH~
City nf Oshlwsh
In!;!:'ecril)1l Services Division
POBox. 1130
Ol:lh~Q~h, WI 54903..1130
['hOI1C; (920) 2~6.50SI)
JI~x: (920) 236..5084
Plumbing Permit Application
I hereby l1pply (or fl. "em-tit to do ~.nd install the (i)l1owlug pl.umbing OJ:! the f)l'omiJ;es hereinafter descdbe.d.. tbe work to conform to the
Wistonsin St:al:~ Pll.I.llI.billg CoOt:, in the performance of which all partie~ h~~rl:f(.\ agrc(\ tl).m(l :!ITt': oooml hy Ilaicl .~tatutef;.
. Applic.ation(s) tmd fee(s) can be brought to City Hall. Room 205 or ma.iled to Inspection 8ervice~, PO Sf-IX 112&,
Oshkosh WI 54903~ 1 J n. Contrl'lencing work without pe:lm'it.(.<;) will result in fees being doubled 1)1' $ J 00.00 pIllS the
normal permit 'lee, which ever i~ gt'eater.
OR
If vO u (!l:f...(J;..~l!.IJ.!.r-'J. c tQLJ.J(J. ,. tic i (J1J.1i.!!g..i'1..1!!.(;.J:(;~!:..!!fJ.1.ELi .d..~,f;.Q.!!...1!l~! s r e..tn_G 11 d h a l'e ad ell" (7J:.!!....O'J!!!!"'~.,..d!.g,k he rc
'if'VQU want t!tis l)l...o..r;,1b.'G~e.d throuqf1 vour ac:cormL::..!:B"-
OSingle Family
Dou pie-x
~ Cont.racto,'
~UJti-FamilY
V~lu~.(lnC1udinglallOr8ndmnlDl'iSl~L1.""y..~_.._ Date /-)1..01
':[ R A 5_"~~~..~/?...E;.~._...2-..l~ ( j; f'! c.. (
~entaJ OComanercial Dlndnstri~l
.Job Address_L:J___A- L-HLth-
...,
I
Owner
Number of Fixtu.res:
f).\!.Jll~l{\
WhirlllOlll
I J1Vlltory
ToileT
Re.. Sink
AliI' Sink
Wlll.cr HIll)4" =J~~
(i GM ~iccll..1 ....wrVl\~
.5h(lw~r
l'llW)r Orllin
l..ndry Tm)'
T..lIhSin1c
.'laslcl.Sin!(
Slerili7'cl"
Lndry SI~l1d~'
[>is"o,'<\'
JJ;shWll~hcr
SUfiIT' l"Jlnp
T::,iccl<>r/Grinrl
Water Sllflll~r
Lncal Wast.c
CIl'tI~s W$l,,"
Bid"-I
T;l,.cI"":\P
C1M~nn !;ink
Penl. Ope.. Shamp Sinl.
Pil1Wc!l F'1r1W~1. 3ink
Drink !'m Ollch I'ta.,jn
W,it.St. WMhl'ln
.k",C.".,~1 Urin31
HX3m ~ink I:;MOnin
S~I}Iy Sink Sndu [li~p
Hand ~ink Cl)ffe.~ Maker
J~ Prcp Sink Ir.~ MilkeI'
Serv Sink Sife Or.i"
Itll (~3S'~ T,<,f' Roof 1.)1'I\,n
F.lIt <irc.1~c Trap S !3f1nJ' ~ec
R.l'.Z. Vi.lve Eye: W>>sh SIn -~-
S\lrer.I""I~ Si"~
BrcnkrmSink
Electric Cont.ractor
~~ liP{'
OR
~ectriC Inst.I.I.tio. Verlfjutio. ronn attJiCbcd
(If RcpI3ccmc:Ilt.)
Use I NatuTe ofWork.____.._.,.._.
~
[~
tv ,.r( ~
Q'
..I:roe
Ml!.teri'.l.l.
Typ~
#
Conn. Type
Ssmi.tary Sewer
St:or.m Sewer
W :dcr S~rviee
"/03
01/ld/2004 87:24 2336747 J RASMUSSEN PAGE 02/82
Electric Installation Verification
(E[ee~ic~ Con,actor Nam~'~< I ~ L LC
(Address) [ ~ .
· (City) (Orate) (Zip
~ave bern COm~act~ ~o pe~o~ ekc~c h~st~llaOon wo~ for ~5
~e ofp~y co~tr~t~d to)
(.Add~s ~he~ work ~o,m~) ~
Tho notre of the work ~stg of: (~eck One or Doscribe ~e Na~ of Worlc)
~ Rec°mectJ°n °r new circ~t for r~plaoement Headng pl~t md/or ~C Condenser.
~ R~conn~6on or u~w 2imuit for replacement Elee~c Water ~eat~ or power vented
-- R~conneclion of tho Se~ic~ En~c~ Cable, Met~ ~ox, ~R~ations to receptacles
~d lighting fixtm~ du~ to ~ifl~g / ~ffit ~t~.[a~o~. Note:
En~nee Cables ~ll r~uire a ~p~ate ~it. N~ Se~ico
~ R~ec~°n °r new cim~t for ~e r~lacm~t of oth~ penn~tly wired
~ Newcircuitf°rtheaddilionof~C~anindivldualdwelli,gunit~o~aeorfl~e
indi~du~ systems Jn a dupI~ or condominium), h~cluding requital service
elec~ic~ outlets.
~ Otil~
Tile value of this work is Sm t/'J'~ o,) ~ ~
I hereby verify this work will be performed by an employes of this company and garffter veri£y
the lx~;oilnectJon / installation wil! be dolle in compliance with manafaclum: and Electric code
requirements.