HomeMy WebLinkAbout0103498-Plumbing (water heater)OSHKOSH
ON THE WATER
.lob Address 2235 WHITE SWAN DR
Contractor JNL PLUMBING
Bathtub 0 Shower 0
Whirlpool 0 Floor Drain 0
Lavatory 0 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 0
Bar Sink 0 Dishwasher 0
Water Heater 1 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner RICHARD B HARRON
Category 411 - Residential-Water Heaters
No 103498
Create Date 08/13/2003
Plan
Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
Water Soffner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
LocalWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Beer Tap 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 0
Lab Sink 0 Plaster Sink 0 Standp Rec 0
Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature SFR/Install electric water heater. *EIV form from Zimmer Electric.
of Work
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 $400.00 Plan Approval $0.00 Permit Fees $20.00 ~ Permit Voided
Issued By
Date
08/13/2003
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.
Signature Date
Agent/Owner
Address 1111 Minnesota Oshkosh WI 54902 - 0000 Telephone Number
232-7270
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 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
ON THE WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the follo;ving 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 bom~d 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 54903-1 t28. 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 participatin~ in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account [~
Job Address ~35'~ c/~ ,~.~_~ 5c~, ~x Value (Including labor and materials) ~-(fi--O
Owner Contractor ~) txJ ~ }0/t/,~/o ~,~ ~
~ingle Family ['-']Duplex [--]Multi-Family ['-]Rental [-]Commercial
Date
~-]Industrial
Number of Fixtures:
Bathtub LndE~ Standp Dent. Oper.
Whirlpool DisposaI Dip Well
[avatory Dishwasher Drink Fm
Toilet Sump Pump Wait. St.
Res. Sink Ejector/Grind Icc Chest
Bar Sink Water So freer Exam Sink
Water Heater ] Local Waste Seulry Sink
C Gas~ Elect [~ PwrVnt Clothes Wshr Hand Sink
Shower
Bidet F Prep Sink
FIoor Drain
Beer Tap Sere Sink
Lndry Tray Classrm Sink Int Grease Trap
Lab Sink
Surgeons Sink Ext Grease Trap
Piaster Sink Brea!crm Sink R;P.Z. Valve
Sterilizer
Electric Contractor ~,~,,,',,,-r /~leci-r, Lc_
Use / Nature of Work
OR
Shamp Sink
Flr/Wst Sink
Catch Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Ice Maker
Site Drain
Roof Drain
Standp Rec
Eye Wash Sm
[-~Electric Installation Verification form attached
(If Replacement)
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
# Conn. Type
7/03
O/HKO/H
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box l 130
Oshkosh WI 54903-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
(Address)
(Electrical Contractor Natne)
(City) (State) (Zip Code)
· I
have been contracted to perform electric Installation work for,'7~[V/-~; t4 ~ ~ 12)~
- (Name of party coniracted to)
at the following address: .,~ ~ ~ ~" I,v~ :-re 3'i,,~A/ 0P'.
(Address where work will be 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.
Reconnection or new circuit for replacement Electric 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.
Recormection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of AfC to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ (~
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
--. r// 21> 3
""(Signatur~ompany Officer).) ' (Date)
(Print Name of Officer)
5/02