HomeMy WebLinkAbout0144460-Plumbing (water heater) 0) CITY OF OSHKOSH No 144460
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 739 MONROE ST Owner MICHELLE R PODOLUSARA SHAFFER Create Date 12/27/2010
Contractor WATTERS PLUMBING 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 Break= 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 #
1107700000
Valuation $658.00 Plan Approval $0.00 Permit Fees
$25.00 1] Permit Voided
Issued By Date 12/27/2010
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 118 MENASHA WI 54952 - 0118 Telephone Number 920 - 733 -8125
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.
/23/2010 THU 10:59 FAX 920 733 2713 Natters Plumbing -+ -P-. OSHKOSH PLB INSPECTION J001 /001
City of Oshkosh
Inspection Services Division
PO Box 1130 069
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 Of -1KOf H
O N THE W A ER
Plumbing Permit Application
I hereby apply for a pemiit 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, Rooin 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.
OR
If you are a contractor participating in the Permit ee Account System and have adequate funds. check here
if you want this processed through your account rasa
** Advisory - For applicable projects, an Electrical 777 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.
Job Address 7 3 P. /4m n« f t� Value (Including labor and materials) G i' Dat / 7. 7 "°
Owner 11 /. // Sire all Contractor k/,e %�„ r / %, �r
Single Family ❑Duplex ❑Multi - Family ['Rental ['Commercial
❑Industrial
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San. Sump /Pump Scullery Sink Soda Disp
Whirlpool Water Softener Servioe Sink Coffee Mkr
Lavatory Standpipe Roc Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitrs Sin
Kit Sink Looal Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice 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 / F Prep Sink Dipper Well Deduct Meter
,Gas U Elect U PwrVnt Ploor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sint:
Wash Fntn Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Electric Contractor (for projects not requiring an EIV Form)
Use Nature of Work ./7Q,/. Ym -aA con✓en✓ n0/ /., 14 de.i ✓.
Size Material Type ti Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
06/09
Received Time Dec. 23. 2010 9:51AM No. 4167