HomeMy WebLinkAbout0145202-Plumbing (water heater) Ifa CITY OF OSHKOSH No 145202
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 818 ECKARDT CT Owner CLARENCE R KOTECKI Create Date 03/21/2011
Contractor KELLY INSPECTION SERVICE LLC 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. * *debit Kitz & Pfeil acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1412920000
Valuation $469.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By 0,y(,:30 Date 03/21/2011
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 5097 SHERMAN RD OSHKOSH WI 54901 - 9755 Telephone Number (920) 284 -1458
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.
T. MAR. 19. 2011 09:35 AM KITZ & PFEIL OSHKOSH tn FAX No, 9202363348 P. 001 /001
of Oshkosh
pection Services Division
P O Box 1130
-
Oshkosh, WI 54903-1130 •
•
Phone: (920) 236 -5050 •
Fax (920) 236 -5084 OJHKOIH
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 permits) will result in fees being doubled or $100.00 plus the normal permit fee, which
ever is greater.
OR
Jfyou are a contractor participating in the Per •t Fee Account S stem a d have ade• uate unds check here
if you want this processed through your account ► l
** Advisory - For appli able projects, an. Electrical Installation Verification (EIV) 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 ` o l l . c, � ,rci+ CA Value (Including labor and materials) �f�p 9• d ° Date B- i 2 1 I
O i er C1-o.]rer./.e. V.,r)-i Contractor Dart Ke,1 l\ •
►�� ingle Family ❑Duplex ❑Multi - Family ❑Rental ❑Commercial ❑Industrial
Number of Fixtures: •
Bathtub Sump Pimp Plaster Sink hoof Drain
Shower San. Sump/Pump Scullery Sink Soda Nap
Whirlpool Water Softener Service Sink Coffee Mkt
Lavatory Standpipe Ilea Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waips Stn
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sisk RPZ Valve Comm Ice Maker
Dishwasher Breakrm Sink Bidet Int Grease nap
Floor Drain Classrm Sink Urinal filet Grease Trap
Hose Bibb Exam Sink Be a Tap Eye Wash Stu
Water Heater Y.. F Prep Sink Dipper Well Deduct Meter
Gas O Elect O PvvrVnt Ploor Sink Drink Fnm Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fnm Wtr Usage Mtr
Lndry Tom' Lab Sink Catch Basin Wise Fixtures
;lectric Contractor (for projects not requiring an EIV Form)
fse / Nature of Work ,a_ • I ___ _ 0 4.- . + 2✓
Size Material Type # Conn. Type � �� 1
_ . ' ' 2 '
Sanitary Sewer
Storm Sewer t •
• Water Service --
Received Time Mar, 19. 2011 9:24AM No. 5004 06'09