HomeMy WebLinkAbout0124326-Plumbing (water heater)
.
OSHKOSH
ON THE WATER
Job Address 409 ALGOMA BLVD
Contractor D.R. HANSEN PLBG.
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner SANDYS OF OSHKOSH INC
Category 441 - Industrial-Water Heaters
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Lab Sink
Sterilizer
Dip Well
Drink Ftn
Shamp Sink
FlrlWst Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
Wait. St.
Ice Chest
Exam Sink
Sculry Sink
Hand Sink
Plaster Sink
Surgeons Sink
F Prep Sink
Serv Sink
No 124326
Create Date 04/20/2007
Plan
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Replace gas water heater. Debit acct
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
0102080000
Valuation
$1,000.00
$0.00
$25.00 0 Permit Voided I
Permit Fees
Plan Approval
Issued By
Date 04/20/2007
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
Address 55 KNAPP ST
Agent/Owner
OSHKOSH
WI 54902 - 3448 Telephone Number 233-1595
Date
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
I:p,~pection Services Division
P~OBox 1130
Oshkosh, VVI54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
~
OfHKOfH
ON THE WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, the work to conform to the
VVisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
· Application(s) and fee(s) can 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, which ever is greater.
OR
I ou are a contractor artici atin in the Permit Eee Account S
ou want this rocessed throuh our account
Job Address '-/0 q A L&o VV\ A. Value (Including labor and materials) / GoO o~ DateL/lz_c~7
Owner .. II A rLOE e: S Contractor 1) 2 ~ 1-1 A",- L C6. (;t./'o ' ,
DSingle Family DDuplex DMulti-Family DRental ~ommercial DIndustrial
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
--.--
\Vater Heater -L-
XGas 0 Elect 0 PwrVnt
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
Fixtures
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrm Sink
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 Comrn. Ice Maker
Serv Sink Site Drain
Int Grease Trap Roof Drain
Ext Grease Trap Standp Rec
RP.z. Valve Eye Wash Stn
Shamp Sink Wtr Sewer Mtrs
FlrlWst Sink Deduct Meters
Wtr Usage Mtrs
Surgeons Sink
Breakrm Sink
DipWelJ
Hose Bibs
Electric Contractor
OR
DElectric Installation Verification form attached
(If Replacement)
Use / Nature of Work
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
VV ater Service
11/05