HomeMy WebLinkAbout151674 - Plumbing (replace pwr vent) g) CITY OF OSHKOSH No 151674
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1227 CEDAR ST Owner STEPHANIE M KLEPPS Create Date 08/13/2012
Contractor RAUSCH PLUMBING Category 411 -Residential-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 FIrNVst 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 POWER VENT WATER HEATER **check#27040
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1204170000
Valuation $203. 0 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
Issued By Cam/ "l Date 08/13/2012
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 1606 W HASKEL ST,STE A APPLETON WI 54914 -5032 Telephone Number 920-830-9222
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.
City of Oshkosh
Inspection Services Division . 0 :
P O Box 1130 01
Oshkosh,WI 54903-1130 0
Phone:(920)236-5050
Fax:(920)236-5084
Plumbing Permit Application
plumbing on the premises hereinafter described,d,the by said statutes.
conform to the
I hereby apply for Sa tate permit m to in and de,in the following P
red to
Wisconsin State Plumbing Code,in the performance of which all parties hereto agree 1'O Box 1128,
Inspection Services, plus the
can be brought to City Hall,Room 205 or mailed to doubled Pr$100.00 p
• Oshkosh WI and 3eels) work without permit(s)will result in fees being
Oshkosh WI 54903-1128. Commencing c eck here
normal permit fee,which ever is greater. a� aYe add, ate nd
OR Ili t
1 ou are a contracts r • i Ir,tli 'I `r � , . , �
,s ed , . . i
r you want this � --, Date
1 R , "-7, St Value(Including labor and materials)
Job Address � ( /rixc � 1 �
l
,,,5 Contractor Industrial
Owner �•� � � Rental ❑Commercial ❑
Single Family []Duplex ❑Multi-Family ❑
Catch Basin
Number of Fixtures: Drink Ftn Wash Ftn
Disposal wait.St.
Whirlpool Urinal —
Whirlpool Dishwasher Ice Chest
Sump Pump Gar Drain -- --
Loilet Exam Sink Gar Drain Ejector/Grind Sculry Sink
R
Toilet Coffee Maker
Water Waste Hand Sink
Res.Sink
Local Waste Comm.Ice Maker
Bar Sink F Prep Sink
Clothes Wshr Site Drain
Water Heater Sery Sink
❑Gas 0 Elect CwrVnl Bidet Roof Drain
Int Grease Trap Standp ail
Shower Beer Tap
Ext Grease Trap Eye Wash Stn
Floor Drain Classrm Sink R.P.Z.Valve
Lndry Tray Surgeons Sink Wtr Sewer Mtrs• Shamp Sink
Lab Sink Breakrm Sink Flr/Wst Sink Deduct Meters
Plaster Sink Dip Well Wtr Usage Mtrs
Sterilizer Hose Bibs
Misc.
Fixtures O1e []Electric Installation Verification form attache_. . Lr___A,,,,,_Electric Contractor (If Replacement) G,�_ib,_, .
G
Use I Nature of Work 2, 't
Size Material Type
# Conn.Type
Sanitary Sewer
Storm Sewer
Water Service 11