HomeMy WebLinkAbout2011-Plumbing (water heater) a CITY OF OSHKOSH No 144864
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1760 ROBIN AVE Owner CHARLES A/MARILYN J PERRY LIVING TRUS1 Create Date 02/10/2011
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 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 Brookside Apts / Replace 80 gal. gas 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 #
1611790000
Valuation $5,800.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By a/7k. .._-
Date 02/10/2011
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.
3
Feb, 9. 2011 :48PM GMS INC
City of Oshkosh
Inspection Services Division
P OBox 3130 No, 7682 P. 1
.
Oshkosh, WI 54903-1130
Phone; (920) 236-5050
Fax: (920) 236-5084 OJHKO/H
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 nail, 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 phis the normal permit fee, which
ever is greater.
OR
./ , • e a c ,- acitic . fin - th . i - Ace, At System e Al awe ade ualq.±andLsiegljars_
- ou lyts ' this r.cessee rot'. A our ccount
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** Advisory 'For applicable projects, an Electrical Installation Verification (ETV) form, signed by the Electrical
Contractoror Homeowner (for initallitions allowed to be performed by the homeowner) must be sabmitted
.. with the permit application. Applications satinitted withoitf an JEW when sash is required, will not he
processed for Nth& Itatiance and will be ietiiiteci for eciilition.
• 0 • •
„ (0
Job Address , lb.. AI a .,,,
v ague (Including lobo and .. — ' is) Bk:51 3 DateAa . j._
Owner ki, S. , k _ ob. IIIR .1 ,Contractor ' _110 sv ar\
OSingle Family °Duplex Dkikultf-Family Kt eel! OCommercial Ejlndustrial
Number of Fixtures:
Bathtub Disposal . — Driak Ftn _ Catch Basin _
Whirlpool Dishwasher Wait St Wifsh Flo __
— _
Lavatory Sump Pump
Ice Chet ____
t Urinal —
_
Toilet EjectodGriud Exam Sink Gra _.....
_
, _
Rm. Sink Water Stetter — Scuiry Sink . Soda Disp
Bar Sink Local Waste
— Hand Sink Coffee Maker ____
_
Heater
Clothes Wshr — F Prep Sink ___ Comm. lee Maker _
Vas 0 Elect 0 PwrViit
Bidet
Sery Sink Site Drain _
_
Shower _ _
Beer Tap
hot Gmose Trap Roof Drain
— _ —
1 Praill
Classrm Sink Extpumse Trap Standp Ric —
—
Lidry Tray
Surgeons Sink 1.P.Z. Vase Bye Wash Stu
ink — ..___
Lab S
lineekrm Sink Shiny Sink %VAT SeWer Mtrs _
Plister Sink
Dii• Well __ Fidnist Sink __ Deduct Meters _
Sterilizer —
Hose Bibs
Wtr U t
sage Mn _
Sterilizer ____
•
41L
'Elecia4e CoutraCtor (for .rojects not requitinOn ETV Form) - .
0 ,
.,U.se / Nature of Woik .. ■. I .1 i • ..... AO 1 . '' . Aft / I_ _IB• • • . • .
,
Size Material TYP # • C.oral• 1N/Pe .
Sanitary Sewer
Storm Sewer
Water Service
____ ._______
• Received Time Feb 9 2011 3.47PM No. 4640 ,
. .....,,, _
Feb. 9. 2011 3:48PM GMS INC No. 7682 P. 2
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Electric Installation Verification
I(We) SLIM'S ELECTRIC INC.
(Electrical Contractor Name)
2608 Oakwood Circle Oshkosh WI 54904
(mss) (►) (State) (Zip Code)
have been contracted to perform electric installation work for �� ,� ►1( _� , 1. ! t iii
I (Name of party contracted • )
at the following I
address: LP 0
(Address where work will be performed)
The nature of the work consists of (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser,
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 / soffit installation. Note: New Service
Entrance Cables will require a separate permit
Reconnection or new cirvuit for the replacement of other per nerdy wired
appliances / fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
individual Systems in a duplex or condone alum.), including required service
electrical outlets.
Other
The value of this
work is $ 31D p,
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacnner and Electric code
reyuircmcnta.
v O fft9j((
1 V� y U n X14 (Signature of Comp car) (Print Name of Offi (D�)
seen
Received Time Feb. 9. 2011 3:47PM No. 4640