HomeMy WebLinkAbout0099280-Plumbing (water heater)OSHKOSH
ON THE WATER
.lob.Address 1300 S KOELLER ST
Contractor WATTERS PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner SHOPKO STORES INC
Category 441 - Industrial-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 Lndry Stndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 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
No 99280
Create Date 01/03/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature COMM/ SHOPKO/ Install electric water heater. *EIV form from Precision Electric.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$815.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date 01/03/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1303 MIDWAY RD, PO BOX 118 MENASHA WI 54952 - 1129 Telephone Number
800-801-8125,733-81
From: 01/02/2003 08:20 #478 P.O02
City o f Osi"iosh
ImpEction Services Division
P O Box 1130
Oshkosh, WI $4903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
Plumbing Permit Application
hereby apply for a pcrmi! to do and install the following plumbing on the premises hereinafter described, the work to conform !o the
Wisconsin Sta!e Plumbing Code, in the performance o£which all pardes herald agree to and are bound by said statutes.
Application(s) and fee(s) can be brought :o City Hall, Room 205 or mailed to Inspection Services, PO Box 1 I28.
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
I£ vou are a contractor partictp.qtfne itL th¢ .P._ermit Eec Account System and have adeouat_e_f_u_nd~, check here
if you Wgltf iht7 ~roce,~,ved through your account ~
Job Address /J'f_.~ -,./':' .,~o,t,.~',c_,/a/,~.Vnlue 0,el,ai,$~,bo,,,d
Owner . .~-d"/,,/z'o~A'"~ Contractor
[-']Single Family [--]Duplex [-]Multi-Family [~Rentnl ]~Commercial [~Industrlal
Number of Fixtures:
Bathtub Lndry Smndl~ Dcm!, Ol~r. Shamp Sink
Whirlpool Disposal Dip Well ~ FIr/War Sink
Lavatory Dishwasher Drink Fin Catch Basin
Toilet Sump Pump Wait. St. Wash Fm
Res. Sink FRject0r/Grind lee Chest Urinal
Bar Sink Water Sofiner Exam Sink Gar l~ain
Water Heater ~ Local Waste Sculry Sink Soda bisp
D Ga~.~f, lilect ~ pwtV~t Clothes Wshr ~ Hand Sink Coffee Maker
Shower Bidet F Prep Si'ak ~ Ice Maker
Floor Drain Beer Tap ~ aery Sink Site Drain
Lndry Tray Classr~ SJ~R In! Grease Trap _. Roof Drain
Lab Sink Surgeons Sink __ Eli Grea~e Trap Sm,~dp Rec
Plast~r Sink Breaktm S~nk
Sterilizer
Electric Contractor /~.~c'.',.~r,.~,,_9.~d'~',,~,~',~.O',R ,~Klectric Installation VerificatiOn form attached
(If Replacement)
Use / Nature of Work
Size
Material Type # Conn. Type
Storm Sewer
Water Service
~/o2
] I'1 C
0]/02/2003 08:24 #478 P.003
FAX NO. : 9207571G]4 Oct. 17 2001 07:06AM
P2
O./HKQYH
Electric Installation Verification
(Electrical Contractor Name)
(City) (Sm~)
have been con~acted to pe~bm elec~c installation work mr
~c ofp~ con~act~ to)
at the following address:_ _
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnecdon or new circuit for replacement Heatillg Plant and/or A/C Condenser.
R¢connection or new circuit for t~placement Elecaric Water I-I~ater.
R~connection of the Service Enlranc~ Cable, M~ter Box, ~lt~ations to receptacles and
iighting fixtures du, to siding / soffit installation. Note: New Service Entrance
Cables will requir, a s~parate
Reconnecti.on or new circtht for other pcmrammfly wired appliances / fixtures.
Oth~
,/.,~< ,~. ,
Tho valuo of this work is $.
I h~eby verify this work will be performed by an employee of this company md further verify the
recorme=tion / installation will be done in compliance with m~nu£~ture, and Elecu'ic code
requirements.
(~natarc of Co~y Officer)
(Print Name of Officer)