HomeMy WebLinkAbout2009-Plumbing (water heater)0
CITY OF OSHKOSH
No 138425
OSHKOSH
PLUMBING PERMIT - APPLICATION
AND RECORD
ON THE WATER
Job Address 606
E MURDOCK AVE
Owner MUZA METAL PRODUCTS CORP
Create Date 10/05/2009
Contractor J RASMUSSEN
PLUMBING
INC
Category 443 - Com'I /Ind- Interior (Replacement Fixtures;
Plan
Bathtub
Clothes Wshr
Classrm Sink
Surgeons Sink
Roof Drain
Deduct Meters
Shower
Lndry Tray
Exam Sink
Sterilizer
Soda Disp
Wtr Sewer Mtrs
Whirlpool
Sump Pump
F Prep Sink
RPZ Valve _
Coffee Maker
Wtr Usage Mtrs
Lavatory
San Sump /Pump
Flr/Wst Sink
Bidet
Site Drain
Misc.
Toilet
Water Softner
Hand Sink
Urinal
Wait. St.
Fixtures
Kit Sink
Standp Rec
Lab Sink
Beer Tap _
Ice Chest
Disposal
Gar Drain
Plaster Sink
Dip Well
Comm Ice Maker
Dishwasher
Local Waste
Sculry Sink
Drink Ftn
Int Grease Trap
Floor Drain
Bar Sink
Sery Sink
Wash Ftn
Ext Grease Trap
Hose Bibb
Breakrm Sink
Shamp Sink
Catch Basin
Eye Wash Statn
Water Heater
1
Use /Nature IND /Replace
of Work
r heater. EIV
Electric.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1519310000
Valuation $600.00 Plan Approval _. $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By Date 10/05/2009
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 GREEN BRIAR TRL
Agent/Owner
OSHKOSH
Date
WI 54904 -8887 Telephone Number 920 - 231 -1289
To schedule inspections please call the Inspection Request line at z36 -bizs noting ine HGGress, rermit mumUer, iyPG vi
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.
10/03/2009 16:03 2336747 J RASMUSSEN PAGE 01/02
City of Oshk-osh
incnPetion Serviro iDlvl9ton
P O Box 1130
Oshkosh, W154903 -1.130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 rL _�/ �► I
Plumbing Permit Application
1 hereby apply fora pcimil: to do a»d install the following plumbing on the premises hereinafter dmoribed, the work to conform to the
Wisconsin State Plumbing Code, in the perfbmancc of which All parties hereto agree it a »d are bound by ca id statutes.
Application(9) and fee(s) can be brought to Ci1y 1-Tall, Room 205 or mailed to .inspection Services, PO Bern 11.28, OAhknsb Wl
54903 -1128. Commencing work without permit(s),trill result in fee_a being doubled or $100.00 plus the normal permit fee, which
ever is greater.
OR /
** Advisory - For appltemble pnrojectx, an Electrical tnstaUlst ioen Verification (EIV) form., sighed by the Electlical
Contractor or Homeowner meowner (fear installittioma allowed to be pm foralled by the homeowner) mast be submitted.
with the pernil: atpplicadiunn. Applicaitiofss sabnritted without as EXV when such is n4 aired, wifl notbc
processed for Pe>tflnlillt isauawce mnd wlill be returned for eonnitpletiani.
�iOQ i' / v
M � r� O V21UC fncludin Iahor and mewriala " 0 ' �� � b 1 2 ,Aob Ad.dreaa� 4 s >_�
Owner _, NU-` -A Contractor _7;1k_ 1`D, SJ— uJs - P I-q 0 t',-'c ,
❑Single Family 01)►nlplex []Multi- Famllly ❑Rental ❑Cotnrnercild JRX dnstlrtal
Number of Mxtnres
B%nitdlh __ --
Sump Pump
Shower
Sall. Svtnp/Purnp _ _. --
Whirlpnni
VlratarSoii.aner , --
LxVat:ety _ .._.
Standpipe Ree –
'rollet
Waitra %tn
Kit Sink
Local WaStc.
Disposal - -, --•,
SarSink _ - -_
Dishwasher
Preakma Sink
Floor Drnin
Classm Sink
Hose Bibh
Pxam Sink _
WAterHe t ar �_..
rP.ropSink __..,r.,....
':1Ciaa i - 1ectCl i`wrVM
Floor Sink
Clothes wilir —__
hand Sinlc
Lndr)r Trgy —..__
Lnh.Sink
Plaster Sink ___
__ Roof Chain
Scullery Sink
So& nisp
Service Sink ^ —__-
Cnf%e Mlcr
slump Sink
Site Drain
Surgeons Sink
Waitra %tn
Starilimr
Ice Cheat _
RP7 Valve _
Comm loo Maker _
Bidet _
, , Int Chvese Tngr
Urinal ,�
__„ Fn lane Trap
Beer Tar _._
P.ye Wash Stn _
Dipper Well
Deduct Meter
mink Fnin —
_ Wir Sewer Mtr _
Waft Pain
Wn•l7aagcMtr
Catch Basin
MiRc Fitttum
.Electric Contractor (for projects not requiring an EIrV Forftn)
Use / Nature of Work 1A4 A,*t-
s
9anitnry Snvcr
Ston'n Sewer
Water Service
Type #
type
oe,ra?
10/03/2009 16:03 2336747 J RASMUSSEN
10/02/2009 09:30 9202317255 BEEZ ELECTRIC
City aFl:OFIft"
D 6 Cfin OF Av eetien Sett icc11
215 Chttich Avanuo
PO look 1130
OaAkoeh Wi 54903.1130
0Mee QN2364050
vn NE wo'-,Eq Fax 92u-Z6-5084
Electric Installation Verification
(I) (We) Beez Electric, Inc.
1901 Oab <'irn Ave Oshkosh WI 54902
have been contracted to�perform electric installation work for Rassumssen ZL=Wng,
at the following address: kQ E,_Murd Ave oshkos _ WI .
Tb,e nature of the work consists of: (Check One or Describe the Nature of Work)
PAGE 02/02
PAGE 01
❑ Reconnaction 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 installation. Note: New Service Entrance
Cables will require a separate permit.
❑ Reconnactlon or new circuit for other permanently wired appliances / fixtures,
❑ other --
The value of this work is $150.00
I hereby verify this -work will be performed by an employee of this company and further verify
the reconnection / installati.on will be done in compliance with manufacturer and Electric code
requirements.
Ggu 13iesiuneaer 10 %201:19
(Signature of Company Officer)