HomeMy WebLinkAbout0142017-Plumbing (water heater & hose bibb) g) CITY OF OSHKOSH No 142017
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 302 W BENT AVE Owner DENNIS M /LINDY S NORKOFSKI Create Date 07/14/2010
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 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 1 Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn
Water Heater 1
Use /Nature SFR / Replace gas water heater and outside faucet. * *debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1502740000
Valuation $650.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By a-
Date 07/14/2010
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.
07/14/2010 06:33 9202311289 J RASMUSSEN PAGE 01/01
City of Oshkosh
1.nspectiern Services Division
PO Box 1130
Oshkosh, W154903 -1130
Phone: (920) 236 -5050
Pax: (920)235 -5084 K0
Plumbing Permit Application rN THE wnrFc
1 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 arc bound by said gesturer_
* 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 plus the normal permit fee, which
ever is greater.
OR
If you area centra Jor ogL .i2WLLtrt_LUhstjP �Iscoam S steer d have adequate fund.s. check here
f ,.y,ottrnuhl v processed thrpurh sour account
*A .Advisory - For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be perfomned by the homeowner) must be submitted
•
with the permit application. Applications submitted without an PTV when such is required, will not be
processed for Permit Issuance And will be returned for completion.
Job Address 3 0.L (A 15 .E nr f Value (Tnclndina lahnr Roo mteri i( l S b �' D 7 /.3 /u
O w n e r _ / U p Fc. o� C i Contractor •ti (Z 0. S w• s s e n• P 1 , .� �. x ,
NiSi ale Rangy Dlhiplex DMniti- Family ❑Rectal
DC(>+minnercial Oladaslrial
Number of Fixtures: • .
Rnthmb Sump Pomp Mester Sink Roe/ Dram
Shower San. Snmp/Pmnp ._ Sculkxy Sink - Soda Dist, •.•.y..•x•.
Wh irlpool Water Softener _ Service Sink -- Coffee Mkr
Lavatory Standpipe Rcc __ __„_ Shanty Sink ---- Site Train
Toils - -•- - � (Tarage FD ... _ Surgeons Sink — warn, Stn
Kit Sink ._ ..�. local Waste - -. Su:Mixer ----- T?iyprwal _..�.._,. Aar Sink .-- ,... -•�.. lac Cheat _
____•.• RPZ Vilve _— Comp k Maker
Dishwasher _ Sink RM --
- - __ l rrt Grease Trap
Floor Dram Claaann Sink Urinal —
•--^ -- --- Eat l'ircaac Trap
Hose Bibb 1 Exam Sink . , --- Bear Tap Rye Waeh Stn
Water Hater _ —
F Prep Sink Dipper Well O w M �
ir,a 0 Elect 0 PwrVm Floor Sink _ Drink Fruit - -- _. —
wtr sewer Mtr
C:Iothca Wahr .._...ti., Hand Sink Wash Pntn . — —
L�tdmy —�� Wtr Map ?der
tab Sink - Catch B0.�
Mix Mimes
Electric Contractor (for projects not requiring an .E.1V .Form)
Use / Nature of Work L'M , fi 4 O k.+ S „4 C 0. of c 4.4 •
— _ Size Material Type # C.otin. Type
Sanitary Sewer
Storm Sewer
Water ,Service
06/09
Received Time 'Jul. 14. 2010 7:12AM No. 1911