HomeMy WebLinkAbout0125174-Plumbing (water heater)
.
OSHKOSH
ON THE WATER
Job Address 306 N LARK ST
CITY OF OSHKOSH No 125174
PLUMBING PERMIT - APPLICATION AND RECORD
I
Owner MELISSA R MEZICK Create Date 06/05/2007
Plan
Contractor MERTEN PLUMBING
Category 411 - Residential-Water Heaters
Bathtub Shower Water Softner Wait. St. Shamp Sink
Whirlpool Floor Drain Local Waste Ice Chest FlrlWst Sink
Lavatory Lndry Tray Clothes Wshr Exam Sink Catch Basin
Toilet Disposal Bidet Sculry Sink Wash Ftn
Res. Sink Dishwasher Beer Tap Hand Sink Urinal
Bar Sink Sump Pump Lab Sink Plaster Sink Standp Rec
Water Heater Classrm Sink Sterilizer Surgeons Sink Ice Maker
Site Drain Breakrm Sink Dip Well F Prep Sink Gar Drain
Roof Drain Ejector/Grind Drink Ftn Serv Sink Soda Disp
Misc.
Fixtures
Use/Nature iSFR / REPLACE GAS WATER HEATER ."check #9871
of Work
Size
Material
#
Conn. Type
Type
Sanitary Sewer
Storm Sewer
Water Service
Valuation $720.00 Plan Approval
Issued By ~S
$0.00 Permit Fees
$25.00 D Permit Voided I
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Parcelld #
1610010000
Date 06/05/2007
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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.
c~ tOifOsh1osh
ImP='1lim. Services Division
P 0 Bar;. IJ 30
OsIKoSJ, WI 54903-1130
PJlJoJtc::(920) 236-5050
F'ax; (9l1J) 236-5084
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Plumbing Permit Application
I It~ apply for a permit to do and install the foRo'Wing plumbing on the premises hereinafter described. the work to conform to the
Wist()nsin State Plumbing Code, in the perfonmance of which aU parties hereto agree to and are bound by said statutes.
. A)Pf?lication( s) and fee( s) can be brought tl}. City Hall, Room 205 or mailed to InspectIon Services, PO Box 1128,
Osbkosh WI 54903-1128. Commencing WClrk ~ithout permit(s) will result in fees being doubled or $100.00 plus the
rumai permit fee, which ever is greater.
OR
l"lJo~{ are.a contractor artici atinCT in i!f1f' Permit Fee Account Svstem and hare ade
i'VOHlf ];raMI' this rocessed thrall h VOUTIlJ:COUl1t
JoQb Address 7,0 b N. ~.
Owmer ~ ~
~SimgIe Family tJDuplex DMmti-Family
Value (Including labor and materials) 721) ,00 Date 5 hlf /07
Contractor ~ , ~~
DRental DCommercial lblndustrial
NlIlIllber of Fixtu res:
l:3atII.nro
~
Lawtlm!
Toilet
Res. ::rim:
Bar Sri
1i.l'aterJfeater I
~:4:S ~= Elect:J PwrVnt
sro~
Fbor Drain
Lndl~(lr.ay
lab Sid.
Plasb:r 5lDk
S1erilielr'
Nisc.
n~
Disposal
Dishwasher
Sump Pump
Ejector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrm Sink
Surgeons Sink
Breakrm Sink
Dip Well
Hose Bibs
Drink Ftn 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
ServSink: 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/Wst Sink Deduct Meters
Wtr Usage Mtrs
Eleetrie Contractor
OR
DElectric Installation Verification form attached
(If Replacement)
U5e J Nature of Work
Size
Material
Type
#
Conn. TyPe I
Sanita"y Sewer
Storm 'SeVYer
Water Service
11/05