HomeMy WebLinkAbout0143210-Plumbing (water heater) CITY OF OSHKOSH No 143210
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 512 520 ALGOMA BLVD Owner BLANKSTEIN ENTERPRISES INC Create Date 04/07/2010
Contractor THE PLUMBING AND HEATING PEOPLE INC Category 446 - Commercial -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 LATE PERMIT/ Replace water heater at 512. "check #5674
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0701670000
Valuation $4,500.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By air'- Date 09/20/2010
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 PO BOX 13542 MILWAUKEE WI 53213 - 0542 Telephone Number (414) 453 -1515
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.
City of Oshkosh - Inspection Services Division - Plumbing Permit Application Page 1 of 2
Division of Inspection Service E C E i \€ D
' 1 4111 )
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903 -1130
f / Fax (920) 236 -5084 AUG 11 2010
Phone (920) 236 -5050
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
PLUMBING PERMIT APPLICATION
All information with * next to it must be provided. Incomplete applications will not be processed.
I 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 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(s) will result in fees being doubled or
$100.00 plus the normal permit fee, which ever is greater.
If you are a contractor participating in the Permit Fee Account System and have adequate funds,
type YES if you want this processed through your account
** 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.
*30B ADDRESS 57,1 - O ■AAA.
*OWNER Q v(A- s4-e -.• ✓- w�'�✓1Q'- se-i
*CONTRACTOR -r t, ie- PtV oi")4 C vN d � + M,t^ - 4 PtoP i e- ` X64 1 L.-t-
*VALUE
COW
*USE *USE CATEGORY
O Single Family O Duplex O Multi - Family Rental Commercial 0 Industrial
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San. Scullery Sink Soda Disp
Sump /Pump
Whirlpool Water Softener Service Sink Coffee Mkr
h ttp: / /www.ci.oshkosh.wi.us/ Community _Development /Inspection_Services /Permit App_... 8/10/2010
City of Oshkosh - Inspection Services Division - Plumbing Permit Application Page 2 of 2
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Waitrs Stn
Sink
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Maker
Dishwasher Breakrm Sink Bidet Int Grease
Trap
Floor Drain Classrm Sink Urinal Ext Grease
Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Stn
Water Heater X F Prep Sink Dipper Well Deduct Meter
X Gas Electric Pwr Floor Sink Drink Fntn Wtr Sewer Mtr
Vnt
Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
*USE / NATURE OF WORK
R L6 c t 1 eevt9 c� L - R
ELECTRIC CONTRACTOR (for projects not requiring an EIV Form)
Size Material Type # Conn. "
Sanitary
Sewer
Storm
Sewer
Water
Service
Submit j [ Reset
http: / /www.ci.oshkosh.wi.us/ Community_ Development /Inspection_Services/Permit App_... 8/10/2010