HomeMy WebLinkAbout0142054-Plumbing (water heater) CITY OF OSHKOSH No 142054
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1126 OHIO ST Owner BRADLEY E /ROBYN A HOLSTEIN Create Date 07/15/2010
Contractor GARTMAN MECHANICAL SERVICES 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 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 #
1300560000
Valuation $700.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By Date 07/15/2010
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 520 W SOUTH PARK AVE OSHKOSH WI 54902 - 6470 Telephone Number 920 - 231 -5530
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.
Jul 15. 2010 1111AM GMS INC
i ll
City of Oshkosh
Inspection Services Division
P 0 Box 1130 No. 2654 P. 1
(
Oshkosh, W154903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084 0/HKO_/1-1
ON THE WATER
Plumbing Permit Application
. r• ••• .• ■•••••■■,.., ...5 / ■ .. • • ••
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 Cod; in the performance of which all panics 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(a) will result in fees being doubled or $100.00 plus the normal permit fee, which
ever is greater.
OR
_ , are a °titre. ar••ar - i•ati • f in t• e Per : ee ; count -m and have adequate funds, check here
i ou w•nt thi •roce . -d thr• 1h • r ac • nt r
• •
. • . .
. . . ... . .. ' . . .
A.4viS ozy - For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Hoxueowner (for installations allowed to be performed by the homeowner) must be submitted
, with the permit application. ApplicarionS submitted withikif an EIV when such is required, will not be
. . . ...
processed for Per,ntt Issiance and will be retained . for cOMpletion.
Job Addresit \\AO 1.),
. Value (including labor sn materials) la) P Datel t,51 ID
. .
17ener ...IAA'. 1 & leti Wei _
ily
k Contractor • C1( /1
ingle Family
ElThapler OlVlulti4arolli Dllental DCommereial
Dindustrial
Number of Fixtures:
Bathmb — —
Disposal . Drink Pin Catch Basin
_
Whirlpool Dishwashe Wail. St
Wash Ft _
— —
Lavatory Sump Pum lee Chest Urinal _
— —
Toilet _ Ejector/Grind .... .Exam Sink • Gm-Drain
Res. Sink Water Seiner Scully Sink • . Soda Disp
-—..._
Bar Sink Local Waste Hand Sink Coffee Maker _
—
—
lea 1 Clothes %lir — F Prep Sink Cconm. lee Maker _
--
E18 0 Elect 0 PwrVnt Bidet Sery Sink — Sfte Drain —
—
Sh .cr — Beer Tap Int GIVUO 'n — ap Roof Dmin _
Floor Drain
Passim Sink • Ext Grease Trap Standp Atm _
LlicilY TM — .. ..
• Surgeons Sink ___ .R.P.Z. Valve ;ye Wash Stu
Lab Sink , . • -
slisimp Bre • -Wirievies Mrs
krin Sink ___ _
—
Plaster Sink
DiPWell ____ Flr/Wst Sink — Deduct Meters
Sterilizer
Hone Bilss
NV& Usage Mtrs _
___
Misc.
-Fixtures ,, .
Electric Contrator (for rejects not requirM EiV Form)
g ; 4
1(.
• . S ize Material TYPE fi. Conn. Type •
•
Sanitary Sewer
•
Storm Sewer
Water Service
•
Received Time Jul. 15. 2010 11:10AM No. 1952 ,