HomeMy WebLinkAbout0144973-Plumbing (water heater) (i'D CITY OF OSHKOSH No 144973
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 619 BOYD ST Owner J 0 HEBBLEWHITE Create Date 02/23/2011
Contractor D R GLAZE 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 Breakrm Sink Shamp Sink Catch Basin Eye Wash Statn
Water Heater 1
Use /Nature SFR / Replace gas water heater. NOTE: Owner listed as Joe Knutson.
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0405840000
Valuation $775.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By a Date 02/23/2011
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 1865 JAMES RD OSHKOSH WI 54904 - 6873 Telephone Number 920 - 589 -4014
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.
City of Oshkosh
I /
Inspection Services Division V;i ID p l
P O Box 1130 ���ttt
Oshkosh, WI 54903 -1130 4 ;,N
` -19-
Phone: (920) 236 -5050 �` ("
Fax: (920) 236 -5084 A. QJ H
ON THE WATER
Plumbing • ermit 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
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account fl
** Advisory - For applicable projects, an Electrical Installation Verification (ETV) 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 - 130A Value (Including labor and materials) � �7 ` Date 1 72a (1
O ner '- CvluTs i Contractor ,tj Z GLAZE /-IIG-
V[ 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 Service Sink Coffee M
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitrs Stn
Kit Sink Local 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
Watg Heater __L F Prep Sink Dipper Well Deduct Meter
GW 0 Elect 0 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink 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 74%.7(.0._ 11 S S. /LO r l'i 474' (C -.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
EC E I V ED
Water Service F E 2 2011
DINB 3 E B E i t F
CO TTY DEVE L OP MENT
INSPECTION SERVICES DIVISION 06/09