HomeMy WebLinkAbout0141727-Plumbing (water heater) CITY OF OSHKOSH No 141727
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1125 N EAGLE ST Owner EVERGREEN MANOR INC Create Date 06/28/2010
Contractor J RASMUSSEN PLUMBING INC Category 411 - Residential -Water Heaters 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 FIr/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 electric water heater. EIV signed by Slim's Electric. * *debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1608640000
Valuation $600.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By arfrn /y Date 06/28/2010
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 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 8887 Telephone Number 920 - 231 -1289
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.
06/27/2010 09:50 9202311289 J RASMUSSEN PAGE 01/02
City of Oshkosh
inspection SerViCEC Divi6I011
PO Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (924) 236 -SO84 .
r.7N THP wins
Plumbing Permit Application
i hereby apply for a permit to do sold 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 am bound. by said statutce.
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosb WI
549034128. Commencing work without permit(s) will resuh in fees being doubled or $100.00 plus the normal permit fee, Which
ever is greater.
OR
I you u rg,�q onf_�_
cr__aor.
ct a r t / . - e , er i. F ,; ccf . SJleln.an4 tbz a ggej to ,ip check hem
i ,.E.A .a F ynrlr. accPttelL- v
** Advisory - For applicable projects, an Electrical xnstall*tion Verification (EIV) form,, signed by the Electrical
Contractor or llomeowner (for installations allowed to be pe fotnmed by the homeowner) mast be snbmittcd
with the permit applicaleimn. Applications submitted iwithont an EN whoa such is requited, will not be
processed for Permit Issuance and will be returned for completion.
.lob Address / / �. S L 4 Value (>nch daps kihor and menu+) 4 0° r --- Date t - / e " /0
Owner C' ✓ )..r IlAtii. Contractor t K tO ►K u s S .e P 11 , fir' e
6in Famil DDnplex DMnitit- Family ('Rental []Commercial Dlndnstrial
Number of Fulrtares:
Rath ub - Somp rump Plaster Sink Roof Drain - —
Shower .-- Sump/Pump Scullery Sink Soda Diap
Whirlpool Water CMtener Service Sink Coffee Mkr
lavatory .... Stondpipe Rcc Shoup Sink Site. Drain
Toi1d Garage FD Surretms Sink ^_ _ Waitr4 Stn _
Kit Sink C.ncal Was Sterilizatr Ice Chat
i isposal Hx Sink _. RIZ Valve -- Cnmm Tee Maker _ r_ ._.
Dishwasher _ -_ Tareakrm Sink __..— Bitter - lnc Grease Teap
Floor Droin Classrm Sink -- Urinal !„— Ext. Grease Trap
Exam Sink Btu Tap Eye Wash Stn
Hose Bibb ___ —^^—
Water Mate • _ 1 F Prep Sink Dipper Well — Deduct Metal
L I Goa pled n ParrVm Floor Sink Drink Pun _r _ Wtr Sewer Mtr
Clotho Wahr HRrul Sink __ Wash Pntn War Usage Ma ....
tAidry Tray Loh Sink Catch Basin Misc Fixtures
Electric Contractor (for projects not requiring an ETV Foram)
Use / Nature of Work _ R. e ( &Az i CU Jtf , ,
_ —__ — . ' Size Material Typc # Conn. Type —^
Sanitary Sewer
Storm Sewer
Water Service
O6 /os
Received Time Jun. 27. 2010 10:29AM No. 1668
06/27/2010 09:50 9202311289 J RASMUSSEN PAGE 02/02
06/25/2010 07:52 920 -426 -5249 SLIMS ELECTRIC INC PAGE 01
c = ► oeyao+
ef>o.ecom SaMon
2» Mush Avesta
PO Ban 1130
Mho& VA WWI ISO
am 1, yo : s050
Electric Installation Verification
1(We ,A.'s ; ,. • s
(Electrical Contractor Name)
2._ v ....! _4:, 1 S,
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for Evergreen Ret. Com.
(Name of patty contracted to)
at the tonowL1 g address: 112b N. Eagle
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
_X Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Keoonneetton of the Service Entrance Cable, Meter L4ox, alterations to rweptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
thhance Cables *Al require a separate permit
Reconnection or new circuit for the replacement of other permanently wired
appliances 1 trxtutes.
New circuit fbr the addition of A/C to an individual dwelling unit (house or the
individual systems in e duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ 250.00 .
I hereby verity this wort will be pe rlormed by an employee of tins company and timber verify
the roc . ). i eetron / installation will be done in compliance with manufacturer er and Electric code
L _ to ■ - David A. Youngwjrth 06/18/10
Received Time Jun.27. 2010 10:29AM No.1668