HomeMy WebLinkAbout0123224-Plumbing (water heater)
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OSHKOSH
ON THE WATER
Job Address 2525 GASLIGHT CT
CITY OF OSHKOSH
No
123224
PLUMBING PERMIT- APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner PAUUJANICE HOLTZ Create Date 01/18/2007
Category 411 - Residential-Water Heaters Plan
Water Softner Wait. St. Shamp Sink Coffee Maker
Local Waste Ice Chest FlrlWst Sink Int Grease Trap
Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
Bidet Sculry Sink Wash Ftn RPZ Valve
Beer Tap Hand Sink Urinal Eye Wash Statn
Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Sterilizer Surgeons Sink Ice Maker Deduct Meters
Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Drink Ftn Serv Sink Soda Disp
Contractor LARRY HANSEN PlBG
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
SFRI Replace gas water heater.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1320519000
$700.00 Plan Approval
~;Q
$0.00 Permit Fees
$25.00 0 Permit Voided I
Date 01/18/2007
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 N-1044 TOWER VIEW DR
GREENVlllE
WI 54942 - 0000 Telephone Number 920-757-6863
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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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OJ~IKOJI-1
ON THF V/ATFR
Plumbing Permit Application
.:p~nnit to do and install the following plumbing on the premises hereinafter described, the work to conform to the
t.lt~'Plwnbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
13:..-:"'~'_:'"
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e.:qf~C(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
,~"93:'1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
. .' which ever is greater.
in the Permit Fee Account S stem and have ade uate unds check here
our account
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Value (Including labor and materials)-=:/ 0(1) . C; 0
Contractor LD-V'f\.l Ho.Jr\~Q
DMuIti-Family DRental DCommerciaI
Date
\-- lCo- 0 '7
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DIndustriaI
Lndry Standp Dent OpeL Shamp Sink
Disposal Dip Well Flr/Wst Sink
Dishwasher Drink Ftn Catch Basin
Sump Pump Wail. SL Wash FIn
EjectorlGrind Ice Chest Urinai
Water Softner Exam Sink Gar Drain
Local Waste Seulry Sink Soda Disp
Clothes Wshr Hand Sink Coffee Maker
Bidet F Prep Sink Ice Maker
Beer Tap Serv Sink Sile Drain
Classrrn Sink Int Grease Trap Roof Drain
Surgeons Sink Ext Grease Trap Slandp Ree
Breakrrn Sink RPL Valve Eye Wash Stn
OR DElectric Installation Verification form attached
(If Replacement)
Size
Material
Type
#
COlli!. Type
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