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Home My WebLink About0133584-Plumbing (water heater)OSHKOSH ON THE WATER Job Address 2628 FOND DU LAC RD CITY OF OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD Owner MARY A BRENZEL Category 411 -Residential-Water Heaters Contractor SOPER PLUMBING Bathtub Whirlpool Lavatory Toilet Res. Sink Bar Sink Water Heater Site Drain Roof Drain Misc. Fixtures Use/Nature of Work 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 Scutry 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 Weil F Prep Sink Gar Drain Ejector/Grind Drink Ftn Serv Sink Soda Disp No 133584 Create Date 10/20/2008 Plan Coffee Maker Int Grease Trap Ext Grease Trap RPZ Valve Eye Wash Statn Wtr Sewer Mtrs Deduct Meters _ Wtr Usage Mtrs Valuation $700.00 Plan Approval $0.00 Permit Fees $25.00 ^ Permit Voided Issued By ~~/yJ'Up Date 10/20/2008 In the pertormance 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 AgenUOwner Address 2225 BURNWOOD DR OSHKOSH WI 54902 - 9003 Telephone Number 426-2151 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. City of Oshkosh Inspection Services Division POBox1130 Oshkosh, WI 54903-1130 Phone: (920) 236-5050 Fax: (920) 236-5084 Plumbing Permit Application O HKO H ON THE WATER 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 participating in the Permit Fee Account System and have adequate funds, check here if you want this processed through your account [] ** 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 a ~a P ~ of ~~~-~-Value ([ncluding labor and materials) ~~ , O6 Date ~~~~/'~ Owner Contractor / -~~1X1'~- ^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 Flr/Wst Sink Deduct Meters Sterilizer Hose Bibs Wtr Usage Mtrs _ Misc. Fixtures Electric Contractor (for projects not requiring an EIV Form) U /N f W k ~ , se ature o or Si a Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service 07/07