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G CITY OF OSHKOSH No 115801
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 675 EVANS ST Owner NANCY A BAKER Create Date 08116/2005
Contractor JOHN D RANSOM Category 411 - Residential-Water Heaters Plan
Bathtub ----2 Shower ----2 Water Softner 0 Wait.St. 0 Shamp Sink ----2 Coffee Maker 0
Whirlpool ----2 Floor Drain 0 Local Waste ----2 Ice Chest 0 FlrlWstSink 0 Int Grease Trap 0
Lavatory ----2 Lndry Tray ----2 Clothes Wshr 0 Exam Sink 0 Catch Basin ----2 Ext Grease Trap 0
Toilet 0 Disposal 0 Bidet ----2 Sculry Sink 0 Wash Ftn 0 RPZValve 0
Res. Sink ----2 Dishwasher 0 Beer Tap ----2 Hand Sink 0 Urinal ----2 Eye Wash Statn 0
Bar Sink 0 Sump Pump 0 Lab Sink ----2 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0
Water Heater 1 Classrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker ----2 Deduct Meters 0
Site Drain ----2 Breakrm Sink ----2 DipWell 0 F Prep Sink 0 GarDrain ----2 Wtr Usage Mtrs 0
Roof Drain 0 Ejector/Grind ----2 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Misc. ----2
Fixtures
Use/Nature
of Work
Install replacement water heater (Debit Kitz & Pfeil Account)
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 1102550000
Valuation
$380.00
Plan Approval
$0.00
Permit Fees
$20.00 D Permit Voided I
Issued By
Date 08116/2005
In the performance of this work, I agree to perform all work pursuant to rules goveming 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 strongiy urges the permit applicant to contact the
easement hoider(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Address W5056 PARADISE LN
Agent/Owner
FOND DU LAC
WI 54935 - 0000
Telephone Number 920-922-1987
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.