HomeMy WebLinkAbout0145667-Plumbing (water heater) CITY OF OSHKOSH No 145667
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1662 DOTY ST Owner LYNDA L S HARTMAN Create Date 05/02/2011
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
Use/Nature SFR / Replace gas water heater. * *debit acct
of Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
0306020000
Valuation $750.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By (x1)(2
Date 05/02/2011
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.
05/01/2011 09:47 9202311289 J RASMUSSEN PAGE 01/01
City of Oshkosh
Inspection Servicrs Envision POBoer1130
Oshkosh, WI 54903 -1130
Phone; (920) 236-5050 /� �V / r ,
Fax: (920) 236-5084 C) J f H
LAN 1- WA1 " R
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter desa The work to con:fOtm to the
Wisconsin State Plumbing Code, in the performance of which alt parries hereto agree to and are bound by said statutes.
• Application(s) and fce(s) can be brought to City Hall, Room 205 or mailed to inspection Services, PO Box 11 Oshkosh WI
54903-1128. Commencing work without pertnit(s) will result in fees being doubled or $100.00 plus the normal permit fee, which
aver is greater,
OR
ffyou are a contractor participating in she Fermi F Account vstent and have adi .?late funds. check her, ,
if you want this processed tbrourh your account
** Advisory - For applicable projects, an Electrical Installation Verification (ETV) form, signed by the Electrical
Contractor or Homeowner (far installations allowed to be vex 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.
°b
Job Address / ` " ( °�• � WNW (toclud'etg labor and entitcriala) 7 S • 1 Date 1 / — `/ _ (!
Owner �„� _ Contractor 't 0. S +K u- s t of P I r 2 c •
(Single Fatuity [Dbuplex [{Haiti - Family ❑Rectal (Commercial Dxndustrial
Number of Fixtures: .
13:n,1►tlrb ____-_, Sump Pomp Plaster Sink RnnTDtain --
Shower _ _ _ San. Sump/Pump ___ _ Scullery Sink __ T Soda Dis ,_ ,,,,,
•
Whirlpool - ,,. __._ Wntcr So@cnet �, , _ Service Sink Coffee Mu
Lavatory _, Standpipe Rec —_,_ . Shemp Sink -_,_ Site Dram
1 oiler Garnett T1) _ Surgeons Sink Waits Stn - - -,
Kit Sink ..... [.Dual Waste • Cterili"er _ ___ loe Cheat _-
Disposal — ... Bar Sink _ RFZ Valve - Comm Ire Maker , , _
Dishwasher -_ Weal= _ Bidet _ Int Grease TYBp --
Floor Dram Closstnt Sink Urinal — Ex Orm;15e Trap _ —
Rom Bibb Exam Sink Beer Tap Eye Wash Stn _
Water Homer 1 IT Prev Sink ._ Dipper WelL ,_- ,,,— Deduct Meter ___ .
/pkias III Blear. r. PwAint Floor Sink Drink Fnm _ Wtr Sewer Mtr --
Clotho Weir Hand Sink Wash Fin Wirt/sage My ,—.
Lldry Tiny Lab Sink .. Catch Resin ^ T Miss Sarum .
Electric Contractor (for projects not requiring an EIV Form)
Use / Nature of Work Q--a -e ( 4- 1 �, K ,
_.., _......_.._. — _.. si . Material - -- Type # corm, Type
Sanitary Sewer
Storm Sewer
Water Service:
pr; /n
Received Time May. 1. 2011 10:29AM No.5451