HomeMy WebLinkAbout0128094-Plumbing (sump pump)
G
OSHKOSH
ON THE WATER
Job Address 436 W 8TH AVE
CITY OF OSHKOSH
No
128094
Contractor E C MERI3.~~~J.!'l~_____ ______________________ Category 410 - Residential-Interior
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
PLUMBING PERMIT - APPLICATION AND RECORD
Owner THOMAS P LEIS
Shower Water Softner Wait. St.
Floor Drain Local Waste Ice Chest
Lndry Tray Clothes Wshr Exam Sink
Disposal Bidet Sculry Sink
Dishwasher Beer Tap Hand Sink
Sump Pump Lab Sink Plaster Sink
Classrm Sink Sterilizer Surgeons Sink
Breakrm Sink Dip Well F Prep Sink
Ejector/Grind Drink Ftn Serv Sink
Use/Nature SFR /INSTALL SUMP PUMP **check #23886
of Work
I
I
I
I
I
I
L_
Shamp Sink
FlrlWst Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
Create Date
11/09/2007
Plan
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Size
Material
Sanitary Sewer
Storm Sewer
Water Service
Type
#
Conn. Type
$O.OQ Permit Fees
Parcelld #
0905810100
Valuation $150.00 Plan Approval
Issued By ~
$25.00 D Permit Voided.1 i
------~
Date 12/07/2007
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 1018 W_~Q~I-!i'~~A\,IJ::_______M_ 9_?_rff5_Q~_H____ ____ '!'IlL !5~90~_ - ~1~~____ Telephone Number ~~5=36Q9
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.
City of Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
r
i H"ACPE~MIT APPLICATION \
All information after bold categories must be provided.
: Incomplete applications will not be processed.
. . . . : i..:.j .' . '. ....:i .': .
. Applicatian(s) and fee(s) can be praught to' City Hall, Room 205 or mailed to'lnspectio'n Services, PO Box 1128,
Oshkash WI 54903-1128. Cammenc,ng work without permit(s)will resultin f'eesbeing doubled o'r$100.00 plus the
normal permit fee, which ever is !greater. .!
OR , : . .... ' '.' '. ".:
If YOU are a contractor oarticioatinf! in the Permit fee Account System and have adequate funds, ~heck here
if YOU want this processed throughvour account n
.cI
OfHKOfH
ON ,THE WATFR
JOB ADDRESS /1 r;/ ;(jb ~(1 P1 ('?f.
f<.\'cLd ~s.
r-C, fJ1.e~'-U J::nc
DATE
IP,f6l-0)
I
OWNER
CONTRACTOR
CHECK li!I ALL APPLICABLE
USE CATEGORY
DSingle Family
o Dup lex
,
,
o Multi-Family
DRental
~co'mmercial
OIridustrial
FUEL'
~as
DOil
I
DElectric · DSolid
DSalar
SYSTEM
DNew
DOther
.,. ,
~eplabe
TYPE . . ,
~rced Air DRadiant DSteam DAle oVent oElectric oHot Water DSuppl. oeon. Burner
IS CHIMNEY BEING LINED ~a DY~s- LINER SIZE 6 r1 & MANUFACTURER
Note: All chimneys shall be sized per th~ BTU's being vented.
. ! ~ : "
CIDMNEY TYPE DChimney J:.. k:tehimney B ODirect Vent o Other
flEA T toss OAs Approyed ~xisting fiNo! APplicable~ : 11
BTU ~TE OAs Per Pl~n DVariable J2r0ther Value _ sr:A~ r....!:: tr~:'
DESC~TION OF ALL WORK ~EIl'ib DONE ~h r.e w.: rV'4 ,~
;., '
:: :'
Ifr,.jd~
VALUE (Including labor and all mathials including light fixtures) $
i .
i
!
'P )"' {/ O. ::::
;,~ iz.
)bVFar applicable projects, an 'Electric Inst lation Verification form, signed by the Electrical Contractor, must be
attached. If nat attached ar 90t applicable, a separate Electrical Permit is required.
ELECTRICAL CONTRACTOR !
,
I~
~Q1B
:i
i .. ..
WITZKE ELECTRIC
!
,
i
;
: 1 :::
Cit)' ot'Osbkasll J . : i
0iYisi0n of'IupectiDQ Servlc.es
215 Cb1lnlb A\'CJl1III i
"'.... '::~ : 130 .
O;hkosh WI S4~mO
Ofl"IC~ 9211-236-$0$0
fax 920..236-5'0S4:
!
'NO.798 .11
I
J
, '! ' .
I
I' 1. I
\
i
DEC. 6.2007 8:19AM
! .
l' .
! '
. j
i
. /'!: i
The nature of the work co~ts Qf: (Check One or Describe the Natur~ of Work) .
; · 1 : ' : : .! ~ : ': I
! -X Recod.-uon kJ, circuitf"l": replacemJ HeatingP~ ahdIor A/~ C";"d9~. .
, _ Reconnection pr new circuit f?r replacem~!lt Ele~tric ~a~er Heater o~ power vent~d .
water heater. . .., I! I" , i
Reconnection hfthe Service Entrance Cabl~, Meter Box, alterations tb rec~t~cle~
and 1ightin~ fix~~s due t? siilU.&.!S" soffif ins:atlation.', Note: Ne~ Se~ce I
Entrance qables, WIll reqw:re a separate pemut. ..;: i I
--- Reconh:ction ~r new circuit for the replac~ent pf oth~ permaneT1tl~ wiIif 'i i
applIances Y :fixnp-es. !. i.... Ii i: i:
-'- N ew c~rcuit fot the .l\ddition o( Ale to an ind,tvidUal dlf~llingunit (ho~e 0* th,e
inqividual systems in a duplex or condominium), incldding requi~ seljviQe
electrical oJ,ltletsl; . . .
Other'
:t
.\
I
\
.l-
I
j.
The value of this wclrk is S JJS. 00
\ . .. . i. I
thereby verify this ~ork will be ~erformed by an employ~e of this 90mpanyand fu!therlv~fy I
the reconneotion I installation will be done in compliance with manufacturer and El~ctri9 co,de 1
requirements. I I ! ,! i i I; !
,. ! I ! !
i
j i
; [, I
I~ -fp-O,;- '. I
- : -'''
(pate) I
i t
I I
I
I
I
I
:L~ ~~
'(Signature of Company Officer).
: '.[ ,
0' r\ 10 \~!
(Print Name of Officer)
I
I
slQ2
I
I
I