HomeMy WebLinkAbout0144740-Plumbing (water heater) (D CITY OF OSHKOSH No 144740
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3184 BELLFIELD DR Owner JOHN W BODA Create Date 01/25/2011
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 FINWst 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 #
1381660000
Valuation $650.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By aiir.,<7 Date 01/25/2011
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 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.
01/25/2011 08:55 9202311289 J RASMUSSEN PAGE 01/01
City of Oshkosh
Mageetion Services D1vI810[1
P O 'Box 1130
Oshkosh, WI 54903 -1130
Phone: (920) 236 -5050 •
Fax: (920) 236 -5084 V J I I II�
I
nni " I F WINTER
-I
• Plumbing Permit Application
1 hereby apply for a permit to do and instmll the following plumbing on the premises hereinafter described, the work to conform In the
Wisconsin State Plumbing Code, in (fie performance of ayhich all parties hereto agree to and are bound by said statutes. •
• Applications) and foe(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI
154903-1128. Commencing work without permit(a) will result in fees being doubled or $100.00 phm the normal permit fee,, which
ever is greater.
OR
r , u •r• , _,, , I , . 'r. ' z , ' „ . f- , _, sent aed _hm , e atdEyt�are check �ierg,
if voDr... 'PO,i<3.hGf.Rwer€f,Y€l through your account
** Advisory - For applicable projects, an Electdcal Installation Verification (E1V) form, signed by the Electrical
Contractor or Homaeownet (fox installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such is test fired, will not be
processed for Pcrinni t Issuance and will be returned for completion.
.Toh Address 3 I S LI lk 1 f -, t I a Pr. Value (Ine;ir►ding hrtmr +nd materials) _ - 6_ r _ - Date /— Z /— /1
g o ktk Contractor .t It m S 04,44, s S t A P 14 , / ,
[, Single Family DDnples DMniti- Family []Rental DConamercial Dindnstrial
Number of Fixtures:
Rat iuh — S►ttnp NM Plaster Sink ttnol Drain
Shower m, Sump/Pump __ Scullery Sink -, __.,. Soda Div
Whirlpool Water Snficete t Service Sink - • Cofac Mkr - _ ---
l.nvaiory Siandpipe Rex _ Shy Sin Site Drain
Toilet: Garage PT} Surgectna Sink „_ __ �, Wsllrs Ski
Klt Sink Local Waste • Sterilizer lee Chest .__.
Disposal _, __ Bar Sink RPZ Valve - . Comm Too Ms t ,,
Dishwnsher _ Weakrm Sink Bidet int Oman Trap
Floor Drain __ Clam-tin Sink _ Urinal 1 Cacmac Trap
Nose Bibb A7 tarn Sink Beer Tap Aye Wash Son -
Water FTenter 1 F Prep sink _ Dipper Well Deduct Meter --- •
'i(1ae (..I T iect Cl PwrVnt Floor Sink _ ,. - Drink Pnm Wtr Seaver Mr •
Clerlte,i Wahl , Hand Sink Wa,h Pntn Wr•Usage Mtr _ - _
Lndr) Tray Leh Sink Catch Basin ... Mkt Plxnrres
Electric Contractor (for projects not requiring an FIV Form) - - - - -
Uae / Natnfre of Worm e.-'ti I c W frt.
,_w..- - -- Size — — i
Mate al .... _ Type * Corm- Type,
Sanitary Sewer
Stnnn Stu
Winer Service _
Q6 /tla
Received Time Jan, 25. 2011 8:36AM No. 4479