HomeMy WebLinkAbout0140047-Plumbing (water heater) O r CITY OF OSHKOSH No 140047
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 421 MERRITT AVE Owner PAUL B SMITH Create Date 03/12/2010
Contractor JOHN D RANSOM 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 4 -UNIT (APT #4) / REPLACE GAS WATER HEATER * *debit Kitz & Pfeil acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0400380000
Valuation $495.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued Bya & Date 03/12/2010
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 W5056 PARADISE LN FOND DU LAC WI 54935 - 9662 Telephone Number 920 - 922 -1987
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.
HU. MAR. 11. 2010 02:37 PM KITZ & PFEIL OSHKOSH FAX No, 9202363348 P. 001 /001
City oP Oshkosh • •
Inspection Services Division •.. :•,, ' •
P O Box 1130 . :: ;; -
Oshkosh, WI 54903-1130 • . ' • •
Phone: (920) 236 -5050 .
Pax (920) 236 -5084 6a �fi. a
N c 7ER
• Plumbing Permit Application
•
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter.describcd, the work to conform to the
• Wisconsin State Plumbing Code, in the performance of which all parties hereto agrca to and arc 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 permits) will result in fees being doubled or S100.00 plus the normal permit fee, which
. ever is greater.
•
OR
I ou are a contractor parti4ipating itt Ole Permit Fee Acc. unt Sys em a d have ade ua e and check here
if tau want this processed through your account fl
•
•** 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_
Soh Address 4,.1 ' ; ' , , 4 _ . _. lue (Including labor and materials) 3 06 O. Date )- ` 1 I — 10
Owner • rr• fa. ,._,•., _ ^ • Contractor r • / /.1
[]Single Family L Dnplex ,Multi- Famil DB. tal NI Commerca DIndustrial
C -- Lin; 4) •
Number of Fixtures: .
•
Bathtub Disposal Drink Pm Catch Basin
Whirlpool Dishwasher Wait St. Wash Fm
Lavatory Strap Pump Ice Ctust Lhriael
Toilet Fdector/Crr nd Exam Sink Gar Drain
• Res. Sims Water SoLner • Sculry Sink , Soda Diap
Bar Sink X.ocai Waste • Hand Sink Coffee Maker •
• Water Hearer x Clothes Wahl • F Prep Sitk • • , Comm. Ice Maker
)EiQat D 1:(aet D Pa rllof Bidet Seav Sink Site Drain
• Shower Beer Tqp Int Grease p Roof Drain
' ' Floor Drain Class= Sink Ext Grease Trap Sip Res .
Ltidry Tray Surgeons Sink • R.P.Z. Valve Bye Wash Sm
Lab Sink Brad= Sink Shrimp Sink Wtr Sewer Mns
Plaster Sink b;p W� Fir/Wat Sink _ Deduct Meters
Sterilizer (lose Bibs• • Wtr Usage Mtrs
Milo.
Fixtures '
Electric Contractor (for p % jests not requiring an EIV Form) • . •
Use / Nature of Work • ' , • / 1/ it �-I
Size Material hype # Conn_ • * * *,t * * * * **
Sanitary Sewer PL 1; USE THE
- • ' . . • KITZ - S PFEZG
Storm Sewer . ACCT'. '
Rater Service Thank You!.
NAN
• 07 07
Received Time Mar. 11. 2010 2:34PM No. 0164
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