HomeMy WebLinkAbout0122293-Plumbing (water heater) 0 .- CITY OF OSHKOSH No 122293
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 972 E SUNNYVIEW RD #22 Owner DAVID M JACOBE Create Date 10/23/2006
Contractor PAUL J FARIS PLUMBING LLC Category 411 - Residential -Water Heaters Plan
Bathtub Shower Water Softner Wait. St. Shamp Sink Coffee Maker
Whirlpool Floor Drain Local Waste Ice Chest FIr/Wst Sink Int Grease Trap
Lavatory Lndry Tray Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
Toilet Disposal Bidet Sculry Sink Wash Ftn RPZ Valve
Res. Sink Dishwasher Beer Tap Hand Sink Urinal _ Eye Wash Statn
Bar Sink Sump Pump Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Water Heater 1 Classrm Sink Sterilizer Surgeons Sink Ice Maker Deduct Meters
Site Drain Breakrm Sink Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Roof Drain Ejector /Grind Drink Ftn Sery Sink Soda Disp
Misc.
Fixtures
Use /Nature SFR/Replace gas water heater. * *DEBIT ACCT * *. Owner listed as Dorothy Adams on permit application.
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
Valuation $500.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By 61-)1*'''
Date 10/27/2006
In the performance of this work, I agree to perform all work pursuant to rules goveming 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 N4571 SHEEHAN LAKE LN CAMPBELLSPORT WI 53010 - 0000 Telephone Number 920 - 979 -8602
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
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 01HKOf 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 count System and have adequate funds, check here
if you want this processed through your account
-
Job Address -2 5k7)Ay11/pc 1 Z2Value (Including labor and materials) cet2 / Date (g 1 1.3(c'
Owner ti /Wa S Contractor a / `T ,,t i5 P�4 t z
gSin,gle Family ODuplex OMulti- Family DRental ['Commercial ['Industrial
Number of Fixtures:
Bathtub Disposal Drink Ftn Catch Basin
Whirlpool Dishwasher Wait. St. Wash Ftn
Lavatory Sump Pump Ice Chest Urinal
Toilet • Ejector /Grind Exam Sink Gar Drain
Res. Sink Water Softner Sculry Sink Soda Disp
Bar Sink Local Waste Hand Sink Coffee Maker
Water Heater (../..---- Clothes Wshr F Prep Sink Comm. Ice Maker
26.0as ❑Elect ❑ PwrVnt Bidet Sery Sink Site Dram
Shower Beer Tap Int Grease Trap Roof Drain
Floor Drain Classrm Sink Ext Grease Trap Standp Rec
Lndry Tray
Surgeons Sink
g R.P.Z. Valve Eye Wash Stn
Lab Sink Breakrm Sink Shamp Sink Wtr Sewer Mtrs
Plaster Sink
Dip Well Flr/Wst Sink Deduct Meters
Sterilizer Hose Bibs Wtr Usage Mtrs
Misc.
Fixtures
Electric Contractor OR ['Electric Installation Verification form attached
(If Replacement)
Use / Nature of Work ` U
Size Material Type # Conn. Type ' A
Sanitary Sewer t) � �
Storm Sewer ''
Water Service `
11 /os