HomeMy WebLinkAbout0144758-Plumbing (water heater) g) CITY OF OSHKOSH No 144758
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 546 ALGOMA BLVD Owner WISCONSIN CHRISTIAN MINISTRIES INC Create Date 01/27/2011
Contractor GARTMAN MECHANICAL SERVICES Category 446 - Commercial -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 FIrIWst 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 Church / Replace power vent water heater. EIV signed by Slim's Electric. **debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0702490000
Valuation $2,300.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By (,Q/ Date 01/27/2011
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 520 W SOUTH PARK AVE OSHKOSH WI 54902 - 6470 Telephone Number 920 - 231 -5530
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.
Jan. 27. 2011 8:09AM GMS INC No. 7393 P. 1 �—
City of Oshkosh ` `
Inspection Services Division
P Box 1130
Oshkosh, WI 54903 -1130
4
Phone: (920) 236 -5050
Fax: (920) 236 -5084 O 1 �(OJH
Plumb ON �K�v.•�T� —
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
(,lyou are ! con actor •.arti (satin • in t - Per • ee Accoun Srsten • nd have adeq-vate funds. check here
i • . ant .is •r, esse hro. h . _ acc, nt
•
*4 Advisory - applicable projects, an Electrical Installation Verification (ETV) form, signed by the Electrical
Contractor,or $omneowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without'an RlV when sash is required, will not be
processed for Pcimit Issatancc and will be leveed for completion.
Job Addres• - A 1 j :It Ai 1, Value oncipdingMorand >s) Date 1 1�� 1i
Owner W , _A t —A • ,,, . R 1 ' .Contractor
LO -
GSingle Fautily °Duplex YN1nln- 1'atnil ental
Y � Commercial I:lndnstrial
Number of Fixtures:
Bathtub Disposal Basin Drink Ptn Whirlpool Dishwasher
Lavatory wit St Wash Fm
Sump Pump Ice C hest
_� Urinal
Toilet Ejector /Grind
Ras. Sink Whim. Rum Sink Gar Drain BarSink W�sr Sotmtr Scuhy Sink Soda Disp
!Local Waste Band Sink Coffee Maker
Water Hea ' Clothes Wsbr FPap Sink
Gas 0 $1 Pwrvnt Comm Ice Maker
Shower Bidet Sav Sink Site Drain
Beer Tap Int Grease T
Floor Dram Roof Dr®
Lsithy May G7as:rm sink Bar Grease Trap st ®dp Rec
I* $iak S Sink •RP.Z Valve Eye Wash Stn '
Bi�a'm Sisk rlaSter Sink bip well Shaaip SiN; VNti Sewer Mira
Sterilizer Ph/Wst Sink ' Deduct.Meters
Hose Bibs
Misr. Wtr Usage Mt
•Pbrtvies
•
Electric Contractor (for .projects not requiring an EYV F orm ) ` 4) .. 1 w �
1.
.TJse / Nature of Work . ••
•
Size Material
TYPe # '. Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
•
.Received Time -Jan. 27. -2011 8:Q8AM,,.No.4521._: _
-. :... , .. ...) I. r. .. . ^.... ..- )...... . _.. r .s.,t„y r- .:.; ;; :::r l�4 r..::. + •n.:!.•j!..t ). \ :�. ,: .� :.t C .` :.. � :1... ` . 5 �� .�
Jan. 27. 2011 8:09AM GMS INC No. 7393 P. 2
City oro,;dash
PO Hoz 1130
etlbak tMl $403 -1130
": 11 . •YAM erns s2anaaoso
- , Fnt 2
Electric Installation Verification
I(We) SLIM'S ELECTRIC INC.
(Electrical Contractor Name)
2608 Oakwood Circle Oshkosh WI 54904
(Address) (hy) (State) (Zip Code)
have been contrasted to perform electric installation work for k. ) CJP't&L . CCuey,ipu
(Name of party con sued to)
at the following address: �
(Address work will be performed)
The nature ofthe work consists of: (Check One or lcscribe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
1 , Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / sort installation. Note: New Service
Entrance Cables will require a separate permit
Reconnection or new circuit for the replacement of other permanently wired
appliances I fixtures,
New circuit for the addition of A/C to an individual dwelling taut (house or the
individual systems in a duplex or condo), including required service
electrical outlets,
Other
The value of tbis work is $ 1 ` .
I hereby verify this work will be performed by an employee of this company and further verify
the won / installation will be done in compliance with manufactures-and Electric code
requirement,.
q a-1 t It
(Signature of Comp! : eer) (Print Name of Offii (Date)
seta
Received Time Jan. 27. 2011 8:08AM No. 4521