HomeMy WebLinkAbout0128278-Plumbing (water heater)
G
OSHKOSH
ON THE WATER
Job Address 139 HIGH AVE
CITY OF OSHKOSH No 128278
PLUMBING PERMIT - APPLICATION AND RECORD
Owner KLRR INC Create Date 12/26/2007
Plan
Category 441 - Industrial-Water Heaters
Contractor J RASMUSSEN PLUMBING INC
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest Flr/Wst Sink
Lndry Tray Clothes Wshr Exam Sink Catch Basin
Disposal Bidet Sculry Sink Wash Ftn
Dishwasher Beer Tap Hand Sink Urinal
Sump Pump Lab Sink Plaster Sink Standp Rec
Classrm Sink Sterilizer Surgeons Sink Ice Maker
Breakrm Sink Dip Well F Prep Sink Gar Drain
Ejector/Grind Drink Ftn Serv Sink Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature ~OMM (STEVE'S TATTOO) / REPLACE ELECTRIC WATER HEATER, EIV SIGNED BY SCHAFER ELECTRIC "debt acct
of Work
Size
Material
Type
Conn. Type
#
Sanitary Sewer
Storm Sewer
Water Service
$0.00 Permit Fees
$25.00 0 Permit Voided I
Valuation $400.00 Plan Approval
Issued By ~
Parcel Id #
0101050000
Date 12/26/2007
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 1914 GREENBRIAR TRL
Agent/Owner
OSHKOSH
WI 54904 - 8887 Telephone Number 920-231-1289
.
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.
!
12/19/2007 10:03
2335747
J RASMUSSEN
(:~
PAGE
01/02
CIlY of Oshk4)/l1'J
InsPf:X"~(m S<:nricer~ Division
p Ol~x 11.30
o.~Jrkl)~b, WI 54903-1 130
.Phone: (920) :1.3!'1..j()50
Fro!: (920) :B6..50l!4
e
(~mI~ ..... ~~llf~
~ ... ...-
~~ r fl-I . '~, A fJ l.l
Plumbing Permit Application
I lll;r:~by llX1Ply (Of.3 pe.lirJ*t I:(l de &nd In(ltlll! th,;; lbllo'vi\lr.; ~~bm"lbillg (m ~he pre:rTl;:<c~l her'eil'll.'l:ftel" di,ls(;rlhcd, lhe work d~) ()~'lIlfomll;O tl,e
Wi~consirl St::lJ:c ,P-lI.II1f\b1ng: C,.)cle, In th~'. p'el.t'::.\li:n".nl~(: ~~fwh;r.lb IfbH i;'I')i~'ic~l h,~rf::t('l ~gree to I,ll1d aro bound hy !laid. :;;ta1:T.l1.es.
. A..p'{illk.al;il;;ll{a).::;l.lf.ld. .f11:e(!\).(~!l.it!. be bro1L\gh1;.l;o, C;~y Hall, Room 205 Cf mailed t01 Jnspoc..1:ioo S~~rvic;es, PO Box .1.128,
OI:1~l~:(I~b WI. .54~0.3...1l28 (~(ll1m:l1eDr:i.ng '1I/<~rk withmll: pl1:l'lnit(s) ')(Iil1 n.~m1t in f(;~e;;, heing o()ubIEl(\ {Jr $1. 00.0<1 plus the
!'!.arroal penult 'li~.., whidl e'ler is e~:e~~t.c;r. . ..,.,,..-,..,,
OR ,/".
lfJ!21LM$...5!. ,{!o.nt!:.~! (: l Ql':...1lfJ1:JJ. f:i.l2.JJ.LL'1.!L.! t!. .t 1J.(i5. .pf;( r..WJ..t~1>.f.;,Q!dJJ.LS.)0);]1.!.!J:LP!"l fi._l1.iLtf..gfl.(}'flUfJ.t..f<'...b.aB.I' ._fil.e(k h II re
~.~!Jl..rl.uh.~~JU(l(,'e.~.~ cd (j!LQl!.$JLl!Q.I.f.l..lJ(;'~.1l..Y.:!U._m
Job Addll".~S!l.../_~..1...jf/j,~______._
Owner S1~'ie,._~.~ I~:t!QQ,....,-
DSllngMe Family DDupKe.x [JIVlhJ1H1tfi-FlIim~Jy
Ci011l1tr~.(:tm"
V;[lh~~ (rl",llJ<:I,T!.'~ 11,\I"!r .1"r1I'\,'''t';rill'~L_._./I..J2..~~..=......_._. OlllC:tE:l..2~.-:!!...:::....~..7
-'r" n.. . ('. =- 'f P l "'-.'
..J ' f" i-\$ lfll\ U ,), 5. :f-.t" ! I C\ i ,.~~ (IJ c-. ,
", .,....'". ".~~ ".~.'-,.--"-'-----,,----''''','''''"'~,.,---'-"''''''''---
[]Relllt3,^ i)aiC~m:!Ilroelrd.:ld Dbllidustll'fial.
Nu.mber o'rF'i.~tllin~.!l:
'~IIf:httlh
Whir)pnrl!
l,[Witl!lT)'
'1'(1;1':1
Ren. f.inlc
l~~'S.lI\I,
'W1ii:1:tJ1' .t,{COfcr ._...1....,_
I i G8Ji i>f21ecI I.J l'wrVnl.
$llUW(l\'
F11l()f Dra:in
Lrrdl.'Y Tr~y
L2b~illl:
Pl~~tcr SInk
SI!:,riI i:1:cr
Misc,
Fllr.lllh,,~
n.;~"n~~ I
Di!\hwOI'lhe,.'
~IITr\1l t"nmJ'
E.i<~CI'rlI'IGrind
'\i{;,"':r.-:l,1n~!I:I'
r,,");mif, ;It"
CRwh BaBin
Wugh PIll
UrillID
Wi,i(.~I:.
If~"; CI'rl-:~r
E"ilm Sj'(1~
G~,'r 1),"11;1,1
tOI::\1 W3f1tC
5(::n h~1 Sip"
T':[{I:d ::;,.ll~
Soil:! DiRl'
(;C()~l": M.Ilke,'
C1ill'il,," W"hl'
~io'l,~t
F rn~p ShIll.
(':oo,m". 1m; Malw.r
Sill: Dr/.lnl
Roof O"II;n
i:it'mdll .R ",c.
F'Ve Wllyh .";~l
'110/11' ~;l)\l'~I' Mtl'~
l)c,dt:(;t Mol:e,'.'
WI!' Una.ge Mtl'o
Scrl'Sinh
~lmll' 1'''1'
/1'11 nn,,,"c '11';11'
I1Kt n"(;~IRC Tra.jl
.c'l".7. V:II'.'t!
S,h.l1'l'mSilllc:
I?h'l'i;V'.l,.Smj,
C}~I~~~I'~t' Sink
S(I\'g\'.'\l!'5 S.il'll<.
13"eulu:1ll Si nk
I)ip 'Wr::ll
f.IM'1 l~~il':j
..~ ~._~~.~.~.~~_.__.____~~~ '-'.Qi-'- . '~~~i:'i~~~~'~ft:t~~~ V erfl'ficat~(bn f~rm a.t.tacb,ed
rtr R~)lh'cl'm::1)1.)
IJsc I Nalll1nJrIt': ~~fWorrk____.~~..._~:~~ ~ tI..
. "'- ........"......"._.,---_._--~----------------_---.....................-
~)J.eltt..k Con1T1l:~ft~r
....',._"..___1_........_ ","",---". -...-.......,.... .....-.. ........;............-., ....--.-.......-.-...----.-....,.." ..... \" ...
Si;;>:e, M!lt~:r.bJ Typ~~ #. ...... ..(~:.~.~: .I.;;p~..~
San1tw'y Sl)w(:I'
Storm :~eW(lr
W~I:ter S~rvijl1(1':
I
.. ... .....__._ __._..._ ........ .._..... ....... ....1
:1/()5
12/19/2007 10:03
2335747
J RASMUSSEN
PAGE 02/02
~
OJHJ<Q/H
ON THf, WATER
City of O~hl(osh
D;vi~ion or '''!1lleeti,m ~rv;"os
215 Chllft:h A"C1\ll~
PO >>ollIIJ(l
(}:;hkosb WI 54902-11)0
Officc 920.1.36-5050
"All 920.23<>-50&4
Electric Installation Verification
Bf(Wc)
J+ e-&~.t~~~.
(ElectncaJ Contractor Name)
_~..u~>~ rei' J9
(Address)
7(~
(City)
;I~'
(State)
_"""~s;,,
(Zip Code)
have been contracted to perfonn electric installation work for 1&-" ~~
(Name of party contracted to)
..._~
a.t the fonowing address: fr.i ~ ~ p.
(Address where work will be performed)
The nature of the work consists of: (ChecK One or Describe the Nature of Work)
2'
Rcconnection or new circuit for replacement Heating Plant and/or Ale Cond.enser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service .Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding I soffit installation. Note: New Service Entrance
Cables will require a separate permit.
Reconnection or new circuit for other permanently whed appliances I fixtures.
Other
------
The value of this work is $_&0' ~
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection I insta.llation will be done in compliance with manufacturer and Electric code
requirements.
~~
(Signature of ompany Officer). .
-~,.. St:.-II/J "~r-
(Print Name of Officer)
-t...'k..:"-I4-.:fL1._
(Dale)