HomeMy WebLinkAbout0143670-Plumbing (water heater) i CITY OF OSHKOSH No 143670
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 629 W 5TH AVE Owner STEVEN H BINDER JR Create Date 10/18/2010
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 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 #
0602330000
Valuation $700.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By a % Date 10/18/2010
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.
10/17/2010 08:10 9202311289 3 RASMUSSEN PAGE 01/01
City of Oshkosh
Inspection Services Division
PO Box 1130
Oshkosh, WI 54903 -1130 . ®
Phone: (920) 236 -5050
Fax: (920)236.508a . 0211M213
ON 'Ng WATER
Plumbing Permit Application
1 hereby apply for a permit to do and install the following plumbing on Site premises hereinafter described, the work to cotttbrm to the
Wisconsin State Plumbing Code, in the performance of which all parties hereto altree to and are bound by said statutes.
a Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO 13ox 1128, Oshkosh WI
54903 -1128. Commencing work without permit(s) will result in fees being doubled or 5100.00 plus the normal permit fee, which
ever is greater. .
OR
if vou are ae• r•_ • ,• •• .1 e '8 „' s.0(4. - - ,• Cr ,..:
yo
if u ortt tAis emaglied SAroy - , • r f nt l'u
*I Advismy - For applicable projects, an Electrical instalhtinln Verification (UV) forte,!, signed by the Electrical
Contractaor or Flaluneowineu (for installations allowed to be performed by the homeowtar) most be s bndtted
with the petrmit application. Applications sub witted without an E1V when such is rued, will not be
processed for Permit Issuance and will be returned for completion. . •
Job Address 6?-c? (j Date / O
1 . value (including and o
p , ^ 7 V� P 1 0 — /2(
Owner N- �� - . D-A Contractor i s l� 0. 5 ow. t,, 1 S N P t 1 t L C
indle Family °Duplex DMuItl- Family °Rental °Comimercial (]I ndustrtsll
Number of.F tares:
Bathtub - Sump Pump Piaster Sink RoofDraif
Shower San, ganrp/Puu _ __, , Sanitary Sink �_,,,^,., Soda Dig) __—
Whirlpool Water Softer a _ Service Sin _ Coffee Min'
lr+& story Standpipe Rec Sharp Sink Site Drain
Toilet Garage FD _ - _ Surgeon& Sink Waitra Stn _,_
Kit Sink Local Worst& Sterillnr ice Chant ---
Disposal _ Bar Sink _, _ RP,Z Valve _ - Coa+m ke Maker _ ,
Dishwasher esraktte Sink Bidet Int Cheese Trap
Ficwr Grain Claserm Sink Urinal kart Grease Top -
Naase BOO+ __ Exam Sitar Seer Tap Bye Wash Stn
Water Heater ( F Prep Sink — Dipper Well Deduct
loss 0 Elect [1 PavrVnt Floor Sink Drink Pram Wir Sewer Mt
Clothes Wshr Rand Sink Wash nun Wtr Linage 1Ntr
Lndry Tray Lab Sink ._ . __, . CJateb .Das*r Mist Flamm _
Electric Contractor (for projects not requiring an EW Form)
Use / Nature of Work 9.--1 `dLt. 4. ,
Size Material Typc # Comm. Type
Sanitary Sewer
Storm Sewer
Water Saxviec
oe /os
Received Time Oct. 17. 2010 8:50AM No. 3296