HomeMy WebLinkAbout0096907-Plumbing (water heater) ilf(?..D CITY OF OSHKOSH No 96907
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1326 INDIGO DR Owner OTIS MIRACLE Create Date 08/28/2002
Contractor RASMUSSEN PLUMBING Category 411 - Residential -Water Heaters Plan
Bathtub 0 Shower 0 Ejector /Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Sery Sink 0 Soda Disp 0
Lavatory 0 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use /Nature SFR/ Replace electric water heater. *EIV form from Drexler Electric.
of Work
Size Material Type # Conn. Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Valuation $400.00 Plan Approval $0.00 Permit Fees $20.00
Issued By VIA Date 08/28/2002
❑ Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
Signature
Date
Agent/Owner
Address 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 8887 Telephone Number 920 - 233 -6747
08/28/2002 17:42 2336747 J RASMUSSEN PAGE 01/02
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903- t 130
Phone: (920)216-5050 - i''�
Fax (920) 236-5084 r' 1
ON 7' -• W/1 r
Plumbing Permit Application
•
I hereby apply fora permit to do and. install dte 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 fcc(s) can be brought in City Pall, Room 205 or mailed to Inspection Services, 1 Box; 1128,
Oshkosh WI 54%1 -112.. Commencing work without pennit(s) will result in fees being doubled or S100.00 plus the
normal permit fee, which ever is greater.
OR
1..k2yjs_re 4..oj ima.cror pgr_ti i. rinry irr thc
slit),. tviltfi this rn_ a t / =r,M h r'Iceor�nr A l en► o »rl /tovw_gfgnru �kttd_s. c(t e.E heat
•
Job Address 1 3 oC 'r.), is D l` Value (tncliitling labor and materials) 4' y D ate g _ >�' -
Uw et' /Vl; r _ ` L Contractor —�
d. w�._.� �`o.� kssEa) P xMc•.
angle Family ]Dnplex ❑Multi - Family DRental rial
❑Commercial �]Iedaetnial
Number of fixtures:
Bathtub _.__._. i.n Swell .
Whir - 0tnt Opt.
Whirlpool __. Disposal ShantpSink
Lavatory — - Dip Well F)r/Ws Sink
-. Dishwasher t)r k Pm Toilet
Sumo Pump - — Catch Resin
Rey. fink -^ Weit. St. Wash Ptn
- .. F.;iccttttKirinA lee Om llrinai
Her Sink. _-._- Water Softiies _ ° .-
Water HeA - _- l=xan +Sink. Ger Drain
kr __ local Waste Sentry Sink
` Gas 1/Fieei n Punvnt
Clothes Wshr t - _.__ Saga I7j, —.M
. _ -�
i
Shower - • aatui Sink
Coffee Make-
- Sidra R Prop Sink
-._.__
Floor Drain
_ r - -
lee Maker T,�
Beer Tap
Lnthy Tray _., -_ ury Sink
-" ('tacsrtn Sink Site Drain
tab Sink Int Grease Trap RnofDrain «• �__
Sucgcnn9 Sink
Cat Grease ,
Plaster :Sink. Smith) Rcc
- 13rrakrnl Sink -- �N __
Electric Contractor _ D n 4 .6 a r .
a•-- Dom, (Electric Installation Verifiicetion form attached
or RcpLicement)
USc / .Nawre or Work G,R
y -- „-- Size Material Type t # Conn. type
Sanitary Sewer
i Storm Scv..c,r
•
I Water Sc iC6
t /52
0 2336747 J RASMRJSSEN PAGE 02!02
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8/28/2002 17:42
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Pas 020436-1144
•
Electric Installation Verification
I nc) ft.EXL EL E`Cr Qt`
(Electrical Contractor Name)
(Address) (�i CKFTI'_
(city) S�{94
(State) (Zip Code)
have been contracted to
perform electric installation work for
' 4 rvi SJ 'tJ FL�
at the folio (Name ofparty contracted to) l �
address: / 3 a `
#.4o i c .
(Address w work will be p
The nature ofthe work consists of )
(Check Oae or Describe the Nature of Work)
, ctieoq 5
Rc �nnectian or n
se nn a tion or new circuit for replacement Hau ply and/or A/C Cond circuit for rreplacement Weenie Water Heater or power enact.
wafer heater.
–_, Reconnection lme of the eryService t y entcd
and cti no flh Se due to n ce ale, Meter Box, alterations to
Entrance Cables will ding / soffit installation. Note: New g epWcles
-t_ �t fbrm a separate permit.
Reeormeetion or new circuit
applian / the replacement of other permanently wired
,
New circuit for
indiviu the motion of b to an individual
ual syt� in a duplex or con dwelling unft (house or the
electrical outlets. nFitttn), including required service
,...__ Other
The value of this work isS 4't7�
1 hereby verify this `° � -1---
the reconnection / • work will be perform by an to
installation will be done in compliance With inn, company r and verify
requirements.
Mric code
(Signature f Company Deb11.
T y Officer) (Print Nam of Of ficer) a te
(Date)
sez