HomeMy WebLinkAbout0132166-Plumbing (water heater)OSHKOSH
ON THE WATER
Job Address 244 N CAMPBELL RD #D
i
CITY' OF OSHKOSH No 132166
PLUMBING PERMIT -APPLICATION AND RECORD
DEBORAH A KOHLBECK
Contractor J RASMUSSEN PLUMBING INC
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Create Date 08/11/2008
411 -Residential-Water Heaters Plan
Shower Water Softner j Wait. St. Shamp Sink Coffee Maker
Floor Drain Local Waste ( Ice Chest FIrIVllst Sink Int Grease Trap
Lndry Tray Clothes Wshr ( Exam Sink Catch Basin ___ __ Ext Grease Trap
Disposal Bidet ~ Sculry Sink Wash Ftn RPZ Valve
Dishwasher Beer Tap ~ Hand Sink Urinal Eye Wash Statn
Sump Pump Lab Sink ( Plaster Sink Standp Rec Wtr Sewer Mtrs
Classrm Sink Sterilizer Surgeons Sink Ice Maker Deduct Meters
Breakrm Sink Dip Well ~ F Prep Sink Gar Drain Wtr Usage Mtrs
Ejector/Grind Drink Ftn Serv Sink Soda Disp
water heater. EIV signed by Cumings Electric. **debit acct
Size 'Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0808040214
Valuation
Issued By
$550.00 Plan Approval $0.00 Permit Fees $25.00 ^ Permit Voided
/~~ j Date 08/11/2008
In the performance of this work, I agree to perform ali 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 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 8887 Telephone Number 920-231-1289
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 pertormed within two business days from the time the project is ready.
08/11/2008 09:00 2336747
City of Oshkosh
Inspection Services Divi910T1
P O fox 1130
Oshkosiz, W1 5 4903- l l 30
J RASMUSSEN
n
PAGE 01/02
Phone (920) 23Cr5050
Fax: (920) 23C-5084 ~ n+i rHa ~,vntrt: .
_ Plumbing Permit Application
1 hereby apply iibr a Dert'ttit to do and install the folTt~ttving ptumbinlt on the premises hereinafter described, the work to conform to the
Wisconsin Scats Plumbing Code, in the performance of which all partit:s hero#o agree to and are l+ound by said statutes.
** Advisory -For. a~licable pmjecte, an Electzttcal >(n~llaoi+on Vezifi,~tion (irk fa~lla, s~lgncd by dtc Electrical
ContCracwr o+r Homeowner (for installations alla~at-ed to he performed lry the ho~ttaeowner) must be submitted
with the perneut appLicazion..t1,~lisatioa-s xelbrT>liitked witl~[ptut an EIV When sash ii4 tneclaixed, will Trot be
processed for Permit itssnance )lu#d will be zeturtted for cotntpletlrnn. Q
Job.tA.ddress ~4 ~ D ~'M`~~~~ Vellue(lncit[ditfalalxrrandtnRtetla)sl ~ ~ _-_, D~te,~~~^4~-
Owner ~. L ~ Contractor ~~ i~ ~ S.S rGN ~ 1 ~ ~ ~NG.~~
~Siingle Fsm~ily ^DapieR nltl-Fan»ly ]Rental OCowr+rn~erciat i»dastrietl
Number of Fixtures:
Bathatb _ Crisposal ,,,.,...^ ~ Drink Fm • Careh F3[[sin __.___
WhirlTtool ,,,,_.,_ Divltwavhe~' __ W[lit. S4 Wasb Fm _
T.,avawry ~~.,.,-. Sump Pump I Ice CI1t>bt Urinttl .-_.._.
1'ollet ~,,,^ ~
Ti,I~tor/GrhtA Exam Sink
-• - Cr~r Drain
~"-
RcS, Sink ~„ _ Watar SO(fiter ~ Scttltti S+1tk Soda ltixp _._....
13nr Sink I
l,ttcal t~'aPte ~__. I~ Haml Sir+k
-- Coft~x MakY.r ..
-
Waticr Hearer ~ Clothes Wyhr' _, F Prep Sink ~ Comm, Ttxt MAkcr
~.1 Gex~lect t.i pwrVnt Bidet ~-
i Sarv Sink ,-_ Site Dtnin ..--~.
ShoN~er 13e~Tnp _---•• i TmC3rense'IYep -,_,,. .., RrxtfThnnt ~..--
Fltwr TA'am ~,.,,_- CI.'+:t.Rrm Sink ~ i F,.xt Grease Trap _ 3tandp Ret:
Lndry, Ttxy __„_- StngCOn9 Sink ,,.,,~__., I R.P.Z., Valve kya tAaeh Stn
l~h Sink ___ .
T3trakrm Oink ___~,r _
I
Sink
3hamp Wtr C~wcr ARtts
N1KStarSink ^,,, j
1JipWell __. FIr/WStCink _.,,,._ _ AcductMetsrq ,,,,,,_
Steriliser
Tinge Sibs __ ~~ Wtr Usalte M[rv
-
Misc.
Electric Contractor (foz projects not requirfing alrw FlV Form)
~~~~ ~ ~
Use /Nature of Work -
Sine Material ' Type # Conn.
Sanitary Sewer
Storm Sewer
Water Service
n~io~
w Application(s) and fee(s) can tie brought to City Hall, lt.~tctm ?..05 or mailed to inspection Services, PO Rax 112R, Oshkosh WT
54903-1 1 2$. Commencing work without permits} will result in fees being doubted or $700.00 plus the normml permit fine, which
--.__ ......e,,.a.
08/11/2008 09:00 2336747
COMINGS ELECTRIC, INC,
J RASMUSSEN
920-72Z-0769
city oro,hkvm
a~~ orn r~K ~
21SQ~ A.enue
PO Bee1130
p~froeel,W1 S~9CS•ll~
TC7{"d'TST~ OtCKe 91D~}b.1a~o
LJJ~~ a. „n.~,.~cna
•.,., ,., v...,
Electric Installatina serif cstio>al
p.1
PAGE 02/02
I (We) tic n~c.'
(Eloctrical Contractor Name)
P O SOZ 749 P1~tA~~ ~ 54957
(City) (State) (ziD Code)
(Addreas) ~ l
leave been contracted to perform elcctria itsrsliation work for ~~ of party contracted i°~
at the following address: tp whew woric will be perforntedy
The nature of ~e work coztsista of (Ch,ack Oac or De6cn'be the Nature of Wank)
_ goon or mew eircvit far replaccmtni Heating PlaOt attd/or A/C pondensa~.
-~ Reoonmecxion oc sew circuit for raplaaement Electric Water Heater or power ve~tod .
~- wear bests. taele>:
Raconnoctiou of tine Service Ezatraacc Cable, lvfeter Box, altuatioas to recap
~ ~,~,g {zttues doe to siding ! soffit mstailation- Notre; New Service
En~traace Cables wY71 tzquuv a separgte pest aneatl wired
Recozmection or new circuit for the repXacemeat of otbet palm Y
' appliances / fioltur~.
J Nc~vv crrctdt for the addition of A!C to an fsdivfduat dwelliayg unil (bow os rvioe
' udividaal sysieims is a duplex or eoudomitu~), including t~quir
clectricsl outlets.
Other
f
•'2y ~ '
The value of this work is 5
I hereby verify this work will be performed by en employee of this company and further verify
the reconnection l installation will be done in compliance with manufactw'er and Electric code
requir~Cments.
i
~I ~z~ s ~ ~ -e .
(Signature enpan fl;cer) ', (Print dame of Otf'ficer) (Date)
srot