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HomeMy WebLinkAbout2011-Plumbing (water heater) (D CITY OF OSHKOSH No 144643 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1408 W 4TH AVE Owner ERIC W VANDENBERG Create Date 01/13/2011 Contractor KELLY INSPECTION SERVICE LLC 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 Kit & Pfeil acct of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service Parcel Id # 0610581000 Valuation $175.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided Issued By o Date 01/13/2011 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 5097 SHERMAN RD OSHKOSH WI 54901 - 9755 Telephone Number (920) 284 -1458 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. RU. JAN, 13, 2011 10;32 AM KITZ & PFEIL OSHKOSH FAX No, 9202363348 P. 001 /001 City of Oshkosh Inspection Services Division POBox1130 ' ® - . Oshkosh, WI 54903 -1130 Phone: (920) 236 -5050 Fax: (920) 236 -5084 Of -IKOJH • ON THE 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 -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 ou are a contractor , artici, atin v in the Permit Fee Account S stem and have a• e uate unds check here • ifvou want this processed through your account fl ** 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 ETV when such is required, will not be • processed for Permit Issuance and will be returned for completion. N/)� ( Job Address 1 O g , la Value (Including labor and materiels) i A? Date f o%, 1/ D o C- _ t A /! JJ J. • ` 4c Contractor Dm . i /4 /f, J 7) ,e .7, 502 • ngle Family ['Duplex i)UMulti- 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 Scrvice Sink Coffee Mkr Lavatory Standpipe Re; Shamp Sink Site Drain Toilet Garage FD Surgeons Sink Waltrs Stn Kit Sink Local Waste Sterilizer Ice Chest Disposal Bar Sink RN Valve Comm Ice Maker • Dishwasher Break= Sink Bidet Int Grease Trap • Floor Drain Classrm Sink Urinal Ext Grease Trap Hose Bibb Exam Sink Beer Tap • Eye Wash Stn Wate atcr / • P Prop Sink Dipper Well Deduct Meter a❑ Elect ❑ PwrVnt Floor Sink Drink Fnm Wtr Sewer Mtr Clothes Wshr Hand Sink Wash Fan Wtr Usage Mtr Lndry Tray Lab Sink Catch Basin Misc Fixtures O 1 Electric Contractor (for projects not requiring an ETV' Forms) / 1 • Use / Nature of Work • ..- Size . Material • Typo # • Conn. Type Sanitary Sewer } Storm Sewer Water Service • Received Time Jan. 13. 2011 10:22AM No. 4362 06/09