HomeMy WebLinkAbout0145201-Plumbing (water heater) 4 ICI) CITY OF OSHKOSH No 145201
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 3346 HARBOR BAY RD Owner MATHEW T /JANE R RICHARDSON Create Date 03/21/2011
Contractor J RASMUSSEN PLUMBING INC 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 FIr/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 Scully 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 electric water heater. EIV signed by Drexler Electric * *debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1550350000
Valuation $600.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided]
Issued By 0 Date 03/21/2011
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 8887 Telephone Number 920 - 231 -1289
To schedule inspections please call the Inspection Request line at 236 -5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
0I3/18/2011 rlcpectinn ServicCS 17:D IVi28 510I1 9202311289
City of Oshkosh sh J RASMUSSEN PAGE 01/02
P n Box 1130
Oshkosh. WI 54903 -1.130 _
Phone: (920) 236 Of -�(( ASH
Fax: (920) 236-5084 ON THE WME.k
Plumbing Permit A pplication
1 hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, the work to
o� to the
Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by
WI
• Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 11. 2$" k fee, which
54903 -1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus permit
ever is greater.
OR S 'st:
if von ,uve a• < aat ones chec _
.t Q_.Ir. �I• t?ar dnizaaE` In the Permit F .cc • PO
Lfy u w >z this rp oc€ a th ovgh y_o> cc_o 1
For applicable projects, an Electrical. Installation Verification (E1V) forms, signed by the Electrical
Contractor or Honneowllltcr (fiolr e ns submit' cd without an ETV when such is required w ea
will not with the permit application. App
processed for Permit Issuance and will be rct�atned for coxupletion. � a n , 1 b� -11(
/� . � .Date 3 -
Job Address 3 3 1 1 U
(-{ f 4 e 7 Value (Including biller end materials).
Owner -
- p. o s a s s P 1 t r,..1 C ,
—_�, 0--,: 0--,: ��ti�� S w Contractor
_____ - .._. — >Indutstriial
[ i ngle Family ❑Duplex DMnIN- Family []Rental []Commercial
Number of Fixtures: .
Sump Pump J'1astta Sink
Roof Drain -- --
F3.� #6tnb �--.- Sada [?iSD —.
Tian. Sump1P'omp Scullery Sink _—._.
Shower __- - -• _ ___ Service ink Correa Mkt
• Whirlpool Water Softener -- —
Shan* Sink Site Drain _
Irmabnry ...._ Standpipe lfea - _.... -.
Surgeons Sink Waitrs Sin
Tnilct Ctarnge FD -- ______ _ _
S Ice Chest
Kit Sink -.__- Local Waste " '- - -""
Disposal _.._ .-- Rar Sink ___
RPZ Valve Comm lcc Maker
Brem ___ Rider Int Grease Trap
Dishwasher ,.,._.... -_ Urinal Ear 13tc tae TraQ
Floor Drain _ _•_ • 011991111 Sink -
Rear Tap Eye Wash Stn
HI= Rihtr - _ -__ Dram Oink .,. -- r Dipper Well Water Auer l F Prep Sink �_�- -.-..- Deduct Meter ._ -
Drink 1'ntn _ -- WV Sewer Ma
L'1 �ras!' Icat pevrVM_ . Fluor Sink — --'
Wash Fntn Wtr Usage Mt+'
Clothes Wshr _ -...- Hand Sink — �..'
l.ah Sink Cant Basin .. - Min Fixtures -
].ndry Tray _ __._ -_
Electric Contractor (for projects not requiring an EJV Form) — ---
Use / Nature of Work IP k 4 _
__.. ,. Size. _ ..,. M — w T ype # Conn. Type
Sanitary Scwer
Storm Sewer
Water Service —_ ____.__ , - _ —__ - -..,- .
asiea
•
Rece Time Mar. 18. 2011 6:10PM No.5002
03/18/2011 17:28 9202311289 J RASMUSSEN PAGE 02/02
46r.) City ofIosh
Division ion of lnspecaee Services
215 Church Avenue
PO Box 1130
Oshkosh W1 54903 -1 DO
U O Office 920.236.5050
/ ON TM[ w. a Fax 920- 736-5084
Electric Installation Verification
I (We) DR..gxi -Pc
(Electrical Contractor Name)
L ia o (O � F PicKCTr ', C
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for 1t S y c
((��, _� ,�� (Name of�party contracted to)
at the following address: _ 3 39 L l'�tWcsK— a 1,
•
(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 AJC Condenser -
?L 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 circuit for the replacement of other permanently 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 condominium), including required service
electrical outlets.
Other •
The value of this work is $ Les
X. 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 manufacturer and Electric code
requirements.
I/
(2 Ai-4
(Signature f Company Officer) (Print Name of Officer) (Date)
Received Time Mar. 18. 2011 6:10PM No. 5002 5/02