HomeMy WebLinkAbout0100470-Plumbing (water heater)OSHKOSH
ON THE WATER
,Job Address 1125 COOLID6E AVE
Contractor CROSS PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner MARVIN P HERGERT
Category 411 - Residential-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 0 BeerTap 0 SculrySink 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
No 100470
Create Date 03/27/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace natural gas water heater.
of Work
Valuation $350.00
Issued B~
Sanitary Sewer
Storm Sewer
Water Service
Size
Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Plan Approval $0,00 Permit Fees $20.00
Date 03/27/2003
[] Permit Voided J
In the perfornTance of thj~ork, I ~/~ree to perform all work pursuant to rules governing the described construction.
SignatureX~%. ~.,.~--'-~,-- ~~ Date (~) ~ --~---
f ~ Agent/Owner
Address PO BOX65 LARSEN WI 54947 - 0000 Telephone Number 303-1255
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
ON TFtE WATER
Plumbing Permit Application
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-I 128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account SFstem and have adequate funds, check here
if Fou want this processed through Four account ~
Job Address ~Y & ~ ~-t:~40&~ ~ Value (Including laborand materials).a.~r
Owner /~.?z~i,~ i~Z~~ Contractor ~--~$S
J~ingle Family [--]Duplex [--]Multi-Family ]--[Rental [--[Commercial
Date
22
[--]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater ,~ (~ Local Waste Sculry Sink Soda Disp
XGas G Elect I2 PwrVnt
Clothes Wshr Hand Sink Coffee Maker
Shower
Bidet F Prep Sink Ice Maker
Floor Drain
Beer Tap Sexy Sink Site Drain
Lndry Tray Classrm Sink Int Grease Trap Roof Drain
Lab Sink
Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink
Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of 'vVork
OR
[-~Electric Installation Verification form attached
Sanitary Sewer
Storm SeWer
Water Service
Size
(If Replacement)
Conn. Type
Material Type #
3/02