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Home My WebLink About0133400-Plumbing (water heater)OSHKOSH ON THE WATER Job Address 150 W 23RD AVE Contractor OWNER CITY OF OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD Bathtub Whirlpool Lavatory Toilet Res. Sink Bar Sink Water Heater Site Drain Roof Drain Misc. Fixtures Use/Nature of Work Valuation Issued By Owner THOMAS W/KATHY S GODDARD Category 411 -Residential-Water Heaters _ Shower Water Softner Wait. St. ___ _ Shamp Sink _ Floor Drain Local Waste Ice Chest FIr/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 1 Classrm Sink Sterilizer Surgeons Sink Ice Maker _ Breakrm Sink Dip Well F Prep Sink Gar Drain _ Ejector/Grind Drink Ftn Serv Sink Soda Disp Date 10/10/2008 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 authori o enforce easement restrictions of which it is not a party, if you perform the work described in this permit a cation wit ' a e e City strongly urges the permit applicant to contact the easement holder(s) to secur ary prov~ls before starting such activity. ~/ Signat Date .~/]~ /i] ~i1 Y Address 150 W 23RD AVE Agent/Owner OSHKOSH WI 54902 - 7072 Telephone Number ~ v scneau~e inspections please can the rnspectlon 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. No 133400 Create Date 10/10/2008 Plan Coffee Maker _ Int Grease Trap Ext Grease Trap RPZ Valve Eye Wash Statn Wtr Sewer Mtrs Deduct Meters Wtr Usage Mtrs $600.00 Plan Approval _ $0.00 Permit Fees $25.00 ^ Permit Voided City of Oshkosh Inspection Services Division POBox1130 Oshkosh, WI 54903-1130 Phone: (920) 236-5050 Fax: (920) 236-5084 O.lHKO~ 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 Wisconsin 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 If you are a contractor partic~ating in the Permit Fee Account System and have adequate funds. check here if you want this processed through your account n ** Advisory -For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted with the permit application. Applications submitted without an EIV when such is required, will not be processed for Permit Issuance and will be returned for completion. /'/ Job Address, SD GcJ , ~? ~ Value (Including labor and materials) ~ ~ ~ G~ Date /`Y rd Owner ~/~ ~~~~~¢~ Contractor Single Family ^Duplex ^Multi-Family ^Rental ^Commercial ^Industrial Number of Fixtures: Bathtub Disposal Drink Ftn Catch Basin Whirlpool Dishwasher Wait. St. Wash Ftn Lavatory Sump Pump Ice Chest Urinal Toilet Ejector/Grind Exam Sink Gar Drain Res. Sink Water Softner Sculry Sink Soda Disp Bar Sink Local Waste Hand Sink Coffee Maker Water Heater ~ Clothes Wshr F Prep Sink Comm. Ice Maker Gas ^ Elect ~_ PwrVnt Bidet Serv Sink Site Drain Shower Beer Tap Int Grease Trap Roof Drain Floor Drain Classrm Sink Ext Grease Trap Standp Rec Lndry Tray Surgeons Sink R.P.Z. Valve Eye Wash Stn Lab Sink Breakrm Sink Shamp Sink Wtr Sewer Mtrs Plaster Sink Dip Well FIr1Wst Sink Deduct Meters Sterilizer Hose Bibs Wtr Usage Mtrs Misc. Fixtures Electric Contractor (for projects not requiring an EIV Form) Use /Nature of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service o~~o~