HomeMy WebLinkAbout0100018-Plumbing (water heater)OSHKOSH
ON THE WATER
.lob Address 136 W 22ND AVE
Contractor GARTMAN MECHANICAL
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner MARGARETA MORTENSON
Category 411 - Residential-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 Water Soffner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 Lndry Tray 0 LocalWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 Lndry Stndp 0 ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100018
Create Date 02/28/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace high efficiency water heater. *EIV form from Beez Electric.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$985.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date
02/28/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 520W SOUTH PARKAV OSHKOSH WI 54902 - 0000 Telephone Number
920-231-5530
City of Oshko~l
Inspection Set ¢ices Division
P O Box 1130
Oshkosh, WI
Phone: (920) 2136-5050
Fax: (920) 236-5084
OJ'HKO./H
ON THE WATER
Plumbin Permit A .... "'lication
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, the work to Conform to th~
Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bqund by said statutes.
[~ingle Family [~]Duplex [-]Multi-Family [--IRentai [--]Commercial [-Ilndustria! '
\
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Fir/Wat Sink
Lavatory Dishwasher Drink Fin Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Rcs. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Oar Drain
Water Heater ~ Local Waste Sculry Sink Soda Disp
Shower Clothes Wshr Hand Sink Coffee Maker
Floor Drain Bidet F Prep Sink Ice Maker
Lndry Tray Beer Tap Sent Sink Sits Drain
Lab Sink Classrm Sink Int Grease Trap Roof Drain
Plaster Sink Surgeons Sink Ext Grease Trap Standp Rec
Sterilizer Brcakrm Sink
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type # Conn. Type
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh W
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
Check here if ~'ou want this processed through },our account []
Electric Instnllnfion Verification
0) (we) Be z lecuic
521 W. l~th Oshkosh ~ 54902
~ve b~ ~~ m p~o~ ele~c ~s~on ~ ~r ~~M~h~c~,
at the following addre~: 136 W. 22nd A~nue.
The nature of the work consists of: (Check One or Describe Rte Nature of Work)
~ion or new circuit for replacement Heating Plant and/or A/C Condenser.
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 / soffit installatio~ Note: New Service Entrance Cables
will require a separate permit.
Rc~rmc~tion or new circuit for other permanently wired appliances / ~Lxtures.
The value ofthis w~k is $15_0.00
I hereby veri~y this work will be performed by an employee oFthis company aud further ver~ the
reco~on / installation will be done in compliance with manufitcturer and l~Iectric code
requirements.
~ Biesin_nm' .0~27/_0~_
(Signature of Company Officer)