HomeMy WebLinkAbout0100640-Plumbing (water heater)OSHKOSH
ON THE WATER
.lob .Address 3355 HARBOR BAY RD
Contractor MERTEN PLUMBING
Bathtub 0 Shower
Whirlpool 0 Floor Drain
Lavatory 0 Lndry Tray
Toilet 0 Lndry Stndp
Res. Sink 0 Disposal
Bar Sink 0 Dishwasher
Water Heater 1 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner MICHAEL C/SUSAN A MILLER
Category 411 - Residential-Water Heaters
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
0 WaterSoftner 0 Drink Ftn 0 ServSink 0
0 Local Waste 0 Wait. St. 0 ShampSink 0
0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
0 Bidet 0 Exam Sink 0 Catch Basin 0
0 Beer Tap 0 SculrySink 0 Wash Ftn 0
0 Dent. Oper. 0 Hand Sink 0 Urinal 0
0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100640
Create Date 04/04/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Install gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$875.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date
04/04/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1087 COZY LANE OSHKOSH WI 54901 - 0000 Telephone Number
231-6795
O~,'.W of OShl~osh
~etion Services Division
POBox 1130
fflsi~kosh, WI 54903-1130
l~a¢: (920} 236-5050
Fax:: (920) 236-5084
Plumbing Permit Application
I ]~ereby apply for a p=.ait 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 a~ee 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,
Oshkost~ WI 54903-1128. Commencing work without permit(s) wilt result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
~o~t are a contractor parricipating in the Permit Fee Account System and have adeauate funds, check here
~f%'o~ Wahl this processed throu£h your account ['~
aob Address 33. 7 Value(Includin§laborandmaumals} C ~C
O~er &~ ~~ Contractor ~)-~
~$~gle Family ~Duplex ~Multi-Family ERental EC 'ommercialf
Date
l~:~mber of Fixtures:
Ela~tab Lndry Standp Dent. 0per. Shamp Sink
l~hirlpool Disposal Dip Well Flr/Wst Sink
La'~ra~ry Dishwasher Drink Fm Catch Basin
lTo~let Sump Pump Wait. St. Wash Ftn
~ Siak Ejector/Grind Ice Chest Urinal
Sink Water Sofmer Exam Sink Gar Drain
',~ater lteater / Local Waste Sculry Sink Soda Disp
~oas 5 Elect 2 PwrVnt Clothes Wshr Hand Sink Coffee Maker
~;l~ower Bidet F Prep Sink Ice Maker
~ Drain Beer Tap Sere Sink Site Drain
Kadry/ay Classrm Sink Iht Grease Trap Roof Drain
[,ab Sink Surgeons Sink Ext Grease Trap Standp Rec
[~a~ter Sink Breakrm Sink
~lectric Contractor
l~s, ! Natare of Work
[-'-]Electric Installation Verificatidn form attached
(If Replacemtmt)
~ Sewer
Sewee
Service
Size
Material
Type
# Conn. Type
3/02