HomeMy WebLinkAbout0107052-Plumbing (water heater)OSHKOSH
ON THE WATER
.lob Address 2530 #C VILLAGE LN
Contractor M P KELLY
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner MONTGOMERY TRUST
Category 441 - Industrial-Water Heaters
No 107052
Create Date 03/24/2004
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 ClothesWshr 0 Ice Chest 0 FIr/VVst 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
of Work
REPLACE ELEC WTR HTR
*EIV HOMEOWNER
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
Valuation $564.00 Plan Approval $0.00 Permit Fees $20.00 ~ Permit Voided
Issued By
Parcel Id #
1320870000
Date 03/24/2004
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 665 N MAIN ST OSHKOSH WI 54901 - 4431 Telephone Number
231-1750
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 O~hkosh
Division of Im~pection S~rvices
215 Chumh A~nue
PO ~ox 1130
Oshkosh WI $4903-1130
O/I-KQ/H o c, o, 2, 5o5o
Electric Installation Verification
/
'" ~ "~ (y~'~cal Contractor~Name)
(Address, - .~'' ~ ,City) (State) (Zi~Cod~)
have been contracted to perform electric installation work for
(Name of party contracted to)
at the following address: .~'--D"-'~) r~~/~/~-'~ '~
- (Addr~s~ where~ork ~11 I~e performed)
The nature of the work consists of: Check One or Describe the Nature of work)
.~; Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
f:i i:i' ,~. Reconnect!on or new;circuit for replacementElectric Water Heater or power vented
water heater. :.'..., .. ;. :
__ Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
__ Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
__ New circuit for the addition of A/C to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required se,vice
elec~cal outlets.
Other
The value of this work is $ ~
I hereby verify this ~VOrk.ill be'pe;f0rm;d by an empi0yee 0fthis company and further verify
the reconnection/installation will be done in compliance with manufacturer: and Ele6tric code
reqUirements. ,,~ ~ ,~ .~:~: ;!:, ,~ I. :~: ~' '
.. ~"-i ......, i, ".:"': -.! · ~
(Signature of Company Officer) (Print Name of Officer) ' (Date)
5/02