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OSHKOSH
ON THE WATER
Job Address 909W SOlJrH PARK AVE
CITY OF OSHKOSH
No
115701
PLUMBING PERMIT - APPLICATION AND RECORD
Owner RUTH ANN BENDER
Create Date 08109/2005
Contractor D R GLAZE PLUMBING
Category 411 - Residential-Water Heaters
Plan
Bathtub 0 Shower 0 Water Softner 0 Wail.SI. 0 Shamp Sink 0 Coffee Maker 0
Whirlpool 0 Floor Drain ~ Local Waste 0 Ice Chest 0 FlrlWst Sink 0 Int Grease Trap 0
Lavatory 0 Lndry Tray ~ Clothes Wshr 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Toilet 0 Disposal 0 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Res. Sink 0 Dishwasher 0 BeerTap 0 Hand Sink 0 Urinal 0 Eye Wash Statn 0
Bar Sink 0 Sump Pump 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0
Water Heater 1 Classrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0 Deduct Meters 0
Site Drain 0 Breakrm Sink ~ DipWell 0 F Prep Sink 0 Gar Drain 0 Wtr Usage Mtrs 0
Roof Drain 0 Ejector/Grind 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Misc. 0
Fixtures
UseJNature
of Work
Install replacement water heater (check # 3898) (EIV MY Electric)
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 Parcelld #
0 1306920000
Valuation
$800.00
Plan Approval
$0.00
Permit Fees
$20.00 0 Permit Voided I
Issued By
Date 08109/2005
In the performance of this work, I a9ree to perform all work pursuant to rules 90veming 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
Address 1865 JAMES RD
Agent/Owner
OSHKOSH
WI 54904 - 0000
Telephone Number
920-589-4014
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.
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¡oy EL:ECTR ¡ C CORP.
920 232 8980
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Electric Installation Verification
I (We) MY Electric Corp.
(Electrical Contractor Name)
¡S121?w;¡bv St.
(Address)
Oshkosh
(City)
jVI
(State)
54902
(Zip Code)
have been contracted. to perfonn electric installation work for D.R. (JIaze Plumbing,
(Name ofparty contracted to)
at the following address; 909 W. South Park Ave
(Address where work will be perfonned)
The naP-ire of the work consists of (Check One or Describe the Nature ofWotk)
- Reconnecûon or new circuit for replacement Heeling Plant andior AlC Condenser.
K...- Reconnection or new circuit for replacement EJec!!'Îc Water H(",ater or power vented
water heater.
- Reconnection ofilia Service Entrance Cable, Meter Bdx, alterations to receptacles
and lighting fixtures due to siding I soffit installation. Note: New Service
Entra.nce Cables will require II separate permit.
- Reconnection or new circuit fur the replacement of other permanently wired
appliances I fiXtures.
- New circuit fur the addition of AlC to an individual dwelling unil (house or the
individual systelIlS in a duplex or ço¡¡dominium), inclu.ding required service
electrical outlets.
Other
The value eftrns work is $500.00
I hereby verify this work wìll be performed by an employee of this company ¡¡.ad further verifY
the reconnection ¡ installation will be done in compliance with manufacturer and Electric code
requirements. .~/~ {~-
.Eli,: Youn¡¡¡þauer () It) ~
(Print Name ofOffiœr) (Date)
TOTAL P.01