HomeMy WebLinkAbout0123693-Plumbing (water heater)
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OSHKOSH
ON THE WATER
Job Address 821 W 18TH AVE
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CITY OF OSHKOSH
No
123693
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner VANIS M BETTIN Create Date 03/06/2007
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 MERTEN PLUMBING
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
SFR / Replace gas water heater.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1411870000
$770.00 Plan Approval
$0.00 Permit Fees
$25.00 0 Permit Voided I
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Date 03/06/2007
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 1076 COZY LN
OSHKOSH
WI 54901 - 0000 Telephone Number 231-6795
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.
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
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Plumbing Permit Application
I hereby apply for a permit t.o cfJO ~ install the following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State PlUlllbimgCode, in the performance of which all parties hereto agree to and are bound by said statutes.
· Application(s) and fee(s} ca:1 be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, whibll e-veF is greater.
OR
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.Job Address f ~ I w. ffi A lte---
Owner ~Vl
~Single Family [JD"pJex
Contractor
Value (Including labor and materiaJs) 770,01> Date O:J./Oi If) 7
tnerffiLp/ hJ' t IH-h-J 'Eh (?,-
ORental OCommercial DIndustriaI
DMulti-Family
Number of Fixtures:
Bathtub
Whirlpool
LavatOlY
Toilet
Res. Sink
Bar Sink
Water Heater ,-
~Gas 0 Elect ~t
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
Fixtures
Electric Contractor
Dis]DaI
~er
SIInJl Pump
EJld!<<iGrind
Wa.l!:rSoftner
L1ai.I Waste
Cblh:s Wshr
BXb;
&.e:. Tap
~Sink
~Sink
Bleiimn Sink
Dip Well
EbleBibs
DrinkFtn Catch Basin
Wait.St Wash Ftn
Ice Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink Comm. Ice Maker
Serv Sink Site Drain
Int Grease Trap Roof Drain
Ext Grease Trap Standp Rec
R.p.z. Valve Eye Wash Stn
Shamp Sink Wtr Sewer Mtrs
Flr/W st Sink Deduct Merers
Wtr Usage Mtrs
OR
OElectric Installation Verification form attached
(If Replacement)
Use / Nature of Work
Sanitary Sewer
S~
Material
Type
#
Conn. Type
J
// 1:; ~
y l~
Storm Sewer
Water Service
11/05