HomeMy WebLinkAbout0145310-Plumbing (water heater) 1(eD CITY OF OSHKOSH No 145310
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 104 E CUSTER AVE Owner LANCE A/SHELLY K RHODE Create Date 04/04/2011
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 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
se /Nature SFR / Replace gas water heater. * *debit acct
� I
of Work
I
I
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1505240000
Valuation $650.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By 0tit/Z., Date 04/04/2011
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.
04/02/2011 11:46 9202311289 J RASMUSSEN PAGE 01/01
• City ot'Oshkoah
in :lion Servnc Division
1
Oshkosh, h .1
Ohkosh, W,f 54903 -1130
\:
Phono :(920)236 -5050
Fax.: (920) 236 -5084 J-K f
4J } T t�
off 11 F W TFR
Plumbing Permit Application
1 hereby apply for a permit to do and install the .foiiow ng plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, in. die performance of which all parties hereto awe= in aril are bound by said statutes.
• Application® and fec(s) can he brought ro City 144, Room 205 or mailed to inspection Services, PO l3ox 11.28 Oshkosh WI
54903 -1128. Commencing work without permit(s) will result in fees be itg doubled or $100.00 plus the normal permit fee, which
over is greater.
OR
If you are a contra .r vrt'ci. -Art! in the ' mil F .cco i sr I, at have adequate fun s.,. heck bent
Y_or_j;pr2g processed throe . .,y rfyagount
"°'"' .Advisory - For applicable pi gjects, an Electrical Installation Verification (ETV) form, signed by the .Electrical
Conixactor or Homeowner (for installations allowed to bc performed by the homeowner) must be submitted itted
with the permit application. .Applications submitted without an ETV when such is required, will not be
processed for Permit Tsaance and will bc returned for completion.
] e;. s -I-e r rye -
job Address D ei G Value (lreeladmgtatrorarnlmazcrittls) 6 s�< ...._.�____. �d 4/ it�!`/ / /
Owner r .. �• 0 Contractor t 1 .0. $ u S S .R ro P (1 ') C
NSin Faintly DDupllex (]Multi- Family DRental DCornmerciai ❑Industrial
Number of Fixtures .
C.toihtub - .. -. Sum 1'wnp . — _ . Plaster Sink _ _.� _. Roof Drain ..,..__� ,...
Shower ' Sim. Sump Vnmp _`_ Satlicry Sink - -•- Soria Diep ___—•
Whirlpool - __,_ _ Water Softenca Service 5�ink Coffee Mkr .
Lavatory . .. Ctandpipe Rcc ._ —__ Shnn7P Sink ._ ... —_ Cite Dram Y _
Toilet (:rnralgc FD Surgeons Sink waitrs S
-
..... M. ,, Sin _.....
Kit Sink Local w1Stc
• .._. s. ^steriNzrx - Ice Chest —.._ ,
Disposal Bar Sink — RPZ Valve ____ Comm ke Maker
Dishwasher _ BreakmtSink -- ,,,,__ Bidet , - int OrDaseTezep ... _
Flynt' Drain • _. _ _.... Claascm Suds Urinal — Der Orcaac Trap —...,..
Hngc Bibb - --- Exam Sink f tzr Tap „ _.._..- Eye Wash Stn __ ..
Water Treater �i _ , F Prep Sink —___ Dipper Well Deduct Mixer _ , „,
*(7nt4 I 1 Elect f ) PwrVnt Ploy Sink Drink Fnte -- Wm Scaler Mir _._
Clothes Wahr Band Sink _ Wadi Prim — __ — Wit Usage Mir
t.ntfry Tray Lab Sink ,„_ Catch Basin Misc Fixture%
Electric Contractor (for projects not requiring an ETV Form) _
the / Nature of Work A a p (a. GA 616,-..f G.f» .�_,__.__
Size t Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
06109
Received Time Apr. 2. 2011 12:28PM No. 5142