HomeMy WebLinkAbout0106546-Plumbing (water heater)CITY OF OSHKOSH
106546
No
OSHKOSHPLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address2440 HAMILTON STOwnerJOHN V/VICKI LEBOUTONCreate Date02/23/2004
ContractorSOPER PLUMBINGCategoryPlan
411 - Residential-Water Heaters
Bathtub0Shower0Ejector/Grind0Dip Well0F Prep Sink0Gar Drain0
Whirlpool0Floor Drain0Water Softner0Drink Ftn0Serv Sink00
Soda Disp
Lavatory00Local Waste0Wait. St.0Shamp Sink00
Lndry TrayCoffee Maker
Toilet00Clothes Wshr0Ice Chest0Flr/Wst Sink0
0
Lndry Stndp
Int Grease Trap
Res. Sink00Bidet0Exam Sink0Catch Basin0
Disposal0
Ext Grease Trap
Bar Sink000Wash Ftn0
Beer Tap0Sculry Sink
Dishwasher
RPZ Valve0
Water Heater100Urinal0
Sump PumpDent. Oper.0Hand Sink
0
Eye Wash Statn
Site Drain000Standp Rec0
Classrm SinkLab Sink0Plaster Sink
Roof Drain000Ice Maker0
Breakrm SinkSterilizer0Surgeons Sink
Use/Nature SFR / REPLACE GAS WATER HEATER
of Work
SizeMaterialType#Conn. Type
Sanitary Sewer0
0
0
0
0
Storm Sewer0
0
0
0
0
Water Service0
0
0
0
Parcel Id #
0
1229290000
$0.00Permit Voided
Valuation$500.00Plan ApprovalPermit Fees$20.00
Issued ByDate02/23/2004
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.
Date
Signature
Agent/Owner
Address2225 BURNWOOD DROshkoshWI54902-0000Telephone Number426-2151
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
POBox 1130
,.Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
~
DEPARTMENT OF OJHKOJH
COMMUNITY DEVELOPMENT ON THE WATER
Plumbing Permit Application
RECEIVED
FEB 1 9 2004
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 broughtto 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
If you are a contractor varticivatinz in the Permit Fee Account System and have adequate funds. check here
if you want this vrocessed through your account n
Job Address ;; ~qd) QAN/~~AI' Value (Including labor and materials) .s--OO'O~ Date ,2-/9-tDV
Owner ~~77tYt/ Contractor $~~ ~~U~/AU:;
~ingle Family DDuplex DMulti-Family DRental DCommercial DIndustrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater -L
$Gas 0 Elect 0 PwrVnt
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
I.ndry Standp
Disposal
Dishwasher
Dent. Oper. Shamp Sink
Dip Well Flr/Wst Sink
DrinkFtn Catch Basin
Wait.St. Wash Ftn
Ice Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink Ice Maker
Serv Sink Site Drain
Int Grease Trap Roof Drain
Ext Grease Trap Standp Rec
RP.Z. Valve Eye Wash Stn
Sump Pump
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrm Sink
Surgeons Sink
Breakrm Sink
Electric Contractor
OR
DElectric Installation Verification form attached
(If Replacement)
Use / Nature of Work
R.yv~""~ r
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
to
7/03