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Home My WebLink About0140008-Plumbing (water heater) I CITY OF OSHKOSH No 140008 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1750 ORCHARD CT Owner DOUGLAS H /RENE L FORSYTHE Create Date 03/10/2010 Contractor SBS PLUMBING LLC Category 413 - Res - 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 SFR / Replace gas water heater. * *debit acct of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcel Id # 1323860000 Valuation $600.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided Issued By Date 03/10/2010 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 Date Agent/Owner Address 4635 RED FOX RD OSHKOSH WI 54904 - 7784 Telephone Number 920 -410 -5933 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 performed within two business days from the time the project is ready. City of Oshkosh Ii iiii i \ Inspection Services Division P OBox 1 Oshkosh, WI 54903 -1130 *IP Phone: (920) 236 - 5050 Fax: (920) 236 -5084 Ofd- -KOJF - -1 ON THE V/, TFF 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 phis the normal permit fee, which ever is greater. OR If you are a contractor participating in the Permit Fe Account System and have adequate funds, check here if von want this processed thronQ {t 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 / 7S"D OdEaki.b a / Value (Including labor and materials) / � ‘ p °r Date 3/3//o Owner PN�.& •cesp7�e Contractor Si6S A.., pi.. ['Single Family ['Duplex ❑Multi- Family ['Rental ['Commercial ['Industrial Number of Fixtures: Bathtub Sump pump plaster Sink Roof Drain Shower San. Sump/Pump Scullery Sink Soda Disp Whirlpool Water Softener Service Sink Coffee Mkr Lavatory Standpipe Rec Sink ��P Site Drain Toilet Garage FD Surgeons Sink Wsitls Stn Kit Sink Local Waste Sterilizer Ice Chest Disposal Bar Sink RPZ Valve Comm Ice Maker Dishwasher Breakrm Sink Bidet Int Grease Trap Floor Dram Classrm Sink Urinal Eat Grease Trap Hose Bibb Exam Sink Beer Tap Eye Wash Stn W eater F Prep Sink Dipper Well Deduct Meter W Ksera U Elect U Pwr nt Floor Sink Drink Fntn Wtr Sewer Mir Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mir Lndry Tray Lab Sink Catch Basin 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 RECEIV MAR 1 0 2010 DEi AK 1 hltiv i OF 06/09 COMMUNITY DEVELOPMENT INSPECTION SERVICES DIVISION