HomeMy WebLinkAbout0151513 - Plumbing (replace water heater) CITY OF OSHKOSH No 151512
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 550 W SMITH AVE Owner DOROTHY F FIRL LIVING TRUST Create Date 08/03/2012
Contractor J RASMUSSEN PLUMBING INC Category 446-Commercial-Water Heaters Plan
Inspector Jerry Fabisch
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 CONDO UNIT/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#
1219720800
Valuation $60000 Plan Approval $0.00 Permit Fees $25.00 El Permit Voided
Issued By (,kJ Date 08/03/2012
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1914 GREENBRIAR TRL OSHKOSH WI 54904 -8887 Telephone Number (920)233-6747(wor■
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
08/03/2012 05:36 9202311289 J RASMUSSEN PAGE 02/02
City of Oshkosh
Inspection Servlces DM5lon
P 0 Box 1130 0
Oshkosh,WI 54903-1.130
Phone:(920)236-5050 J
Y•'ax;(420)236-5084 --
nM 1'HF wATEiR
Di1.mhinn Parmif Annlication
1 hereby apply for a permit to do and install the:fr+llowing plumbing on h premises hereinafter
to and lx bound work
'said statutes.oto the
Wisconsin;State Plumbing Cod;in the performance of which l,p WI
• A.pplicetitn'I(s)and fce(s)can be brought to City 1-1311,Roo205 or being doubled tio$Services,
plus Po Box
normal 1 2 ,Oshkosh
which
54903-1128. 'Commencing work without permit(s)will result
ever Is greater.
OR a its ec ►erP
> >' 23 the_P �. ' ,Agsoun(� t-b_g_mc9[.dear,Vte_fiej-__.c_b L_.-
�.d'. t� '4 v IrQJLr��Q�tor� DQ �tl3...ttt�
**Advicoxy- or applicable projects,a Electrical installation Verification(MINT)form signed by the Electrical
Contractor or Homeowner(for installations allowed to be perrfOrm d by the homeowner)must be submitted
with the permit application. Applications submitted withcnat ran.EIV when such is required,,will not be
processed for Permit Issuance and will be returned for completion.
r C 60� d0 3---F—Iz
J (�< S✓"�' Value(rnchtdine labor end materials) _�—• D�'t_ "�
�TfAl!Address /1 ■ ��J
r L Contractor t 5 nn.u 1 S c r"
Owner —�.,�-' OCommercial ❑Ilndnstris�l
OS1ngIe Family 0Dulplex f Mniti Family OReutai
Number of Fixtures:
Plaster Sink Roof Drain
Rnrimtb _y.,- Sump Pump ------ —T �.�._
6ceillcty Sink Disp
Shower �__. San.Swap/Pump ��_
Service Sink Coffee Mla'
Whirlpool ____ Water Softener ____.
Shame Sink SiteDrain
ra virtory ._.:._— Standpipe Rae -... -+. iMa.itre Sin n
Garage F1) SurgtOnc Sink
Toil et ..,,. — '.• -.__ lee C_hrxt -__.,._-
1:ocal Waste Sterilizer
Kit Sink '--- Comm Ice Make -._--
9ar Sink --_ RPZ Valve - -.-.
[ligpneal htt GreASe Tmp _
Arenkmt Sink ---...- Bidet ..
r)iahWSr rain � „-, Ott Great a Trap .-.--
C1nsarm Sinic Urinal
T1nnr Amin _ __ Eyr_Wash 5m
Exam Sink Beer Tap .�--
Wat Bibb Dipper Well Dotinut Meter _.--..
Water Banter - ; f._ F Prep Sink �.,�r _.__.. -
T)rtrtk lhtln —__ Wlr Sewer Ma
LJ�A 1Klect[1 FturVnt Floor Sink Wtl Sew r.ItAtr
Wash Ftm -- .
Clotho Wshr _.,_ ]'land Sink - Misr: sage ma
Lnrhy Tray' .._...-.. Lab Sink Catch Basin
Electric Contractor(for projects not requiring an EJV Form)_ —_--_—._
Use/Nature of 0rrlt /�'�-P i"-u= - _- _ - .(.0,....h. ,
-�- —.._—. Conn.Type
_. - Size Material �'Ype
Sanitary Sewer
Storm Sewer
Water erviec
•
06/0°
•
Received Time Aug. 3. 2012 6: 23AM No. 0309
08/03/2012 05:36 9202311289 J RASMUSSEN PAGE 01/02
City of
ionofIoph
DiviCipn of Avei e. Service.
4111). 215 Clutch Aveauc
PO Box 1130
Olhhoah W1 54903-1130
Office 920-236-3050
u.+r Fax 920-236-50s4
Electric Installation Verification
I(We) Q-EY,.1e2 L ecT21 c LL C...
(Electrical Contractor N e or -lomeowner's Name)
L1� 0 Coot 2h i e-rf >d 1 - - q
(Address) Ci
( ty) (State) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
5 50 0 i 3 LIB
(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 A/C Condenser.
--Rr- 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,including
required service electrical outlets. Note: Homeowners can only do their own
electric on a single family owner occupied home. Work on a condominium,
duplex, rental, or multi-use building would require a licensed Electrical
Contractor.
Other
The value of this work is $ J'-?' .
-I-hereby-verify this work will be performed in compliance with the License requirements of
Section/ 11-22 of the Oshkosh Municipal code and further verify the reconnection/installation
W'ill•be•done in'compliance with mianufacturer and Electric code requirements.
/// C .__ ti. . t► 11 g-
(Signature of v impany Officer or Homeowner) (Print Name) (Date)
07/07
Received Time Aug, 3. 2012 6: 23Ad No. 0309