HomeMy WebLinkAbout0100638-Plumbing (water heater)OSHKOSH
ON THE WATER
JobAddress 1600 BRENTWOOD DR
6ontractor SOPER PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner RONALDA DUERKOP
Category 411 - Residential-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F PrepSink 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 ServSink 0
Lavatory 0 LndryTray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
BarSink 0 Dishwasher 0 BeerTap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100638
Create Date 04/04/2003
Plan
Gar Drain 0
Soda Disp 0
Coffee Maker 0
Int Grease Trap 0
Ext Grease Trap 0
Use/Nature
of Work
~SFR/
Replace gas water heater.
Valuation
Ely
Issued
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$425.00 Plan Approval $0.00 Permit Fees $20.00
[] Permit Voided
Date 04/04/2003
In the perform, ance of~l~i~work, I agree tq43erform all work pursuant to rules governing the described construction.
Signature ~~-~-"~_.~-"'~.~ Date
I ~--~''' .... '-~- '~ -- Agent/Owner
Address 2225 BURNWOOD DR Oshkosh WI 54902 - 0000 Telephone Number
426-2151
City of Oshkosh
InsPection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/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 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 [-]
Job Address /*_d/~ ~,~_ -_,~.A;,'/z.~a~/9 Value (Including labor and materials)
Owner Contractor ._'~,,~,e,~..
iX]single Family [--]Duplex [-]Multi-Family [--]Rental ~]Commercial
Date
[-]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper.
Whirlpool Disposal Dip Well
Lavatory Dishwasher Drink Ftn
Toilet Sump Pump Wait. St.
Res. Sink Ejector/Grind Ice Chest
Bar Sink Water Softner Exam Sink
Water Heater /" Local Waste Sculry Sink
~kGas [] Elect [] PwrVnt Clothes Wshr Hand Sink
Shower Bidet F Prep Sink
Floor Drain Beer Tap Serv Sink
Lndry Tray Classrm Sink Iht Grease Trap
Lab Sink Surgeons Sink Ext Grease Trap
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work
Sanitary Sewer
Storm Sewer
Water Service
Shamp Sink
Flr/Wst Sink
Catch Basin
Wash Ftn
Urinal
Gar Drain
Soda Disp
Coffee Maker
Ice Maker
Site Drain
Roof Drain
Standp Rec
OR
Size
Material
Type
[--]Electric Installation Verification form attached
(If Replacement)
# Conn. Type
3/02