HomeMy WebLinkAbout0152110 - Plumbing (water heater) CITY OF OSHKOSH No 152110
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 165 CIMARRON CT Owner A M MOKLER PROPERTIES LLC Create Date 09/04/2012
Contractor SKOLASKI PLUMBING LLC 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 MULTI-FAMILY/REPLACE GAS WATER HEATER(1 HEATER SERVES THE WHOLE BUILDING)
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1413350100
Valuation $0000 Plan Approval $0.00 Permit Fees $25.00 El Permit Voided
Issued By �i �I
Date 09/04/2012
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( a•._o ure any necessary approvals before starting such activity.
Signature � _
•
Date r\-
Agent/Owner
Address 1508 AMES ST NEENAH WI 54956 -4702 Telephone Number (920)450-0020
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
P O Box 1130
Oshkosh,WI 54903-1130
Phone: (920)236-5050
Fax: (920)236-5084
O./HKO/H
Plumbing Permit Application ON THE WATER
I hereby apply for a permit 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 agree 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, Oshkosh WI
54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which
ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
iyou want this processed through your account 1
**Advisory-For applicable projects, an Electrical Installation Verification
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be by the Electr
submitted cal
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.
Job Address \\o S L, .^ c::\ Value (Including labor and materials
�`SC)O Date 4i-\k-A
Owner � \t� 4 r. —\-& � \ �onractor �.,\, � , v- -- ,,
❑Single Family ['Duplex �pMulti-Family ❑Rental
^vim ❑Commercial Industrial
Number of Fixtures:
Bathtub Sump Pump
Plaster Sink Roof Drain
Shower San.Sump/Pump
Scullery Sink Soda Disp
Whirlpool Water Softener
Service Sink Coffee Mkr
Lavatory Standpipe Rec
Shamp Sink Site Drain
Toilet Garage FD
Surgeons Sink Waitrs Stn
Kit Sink Local Waste
Disposal Sterilizer Ice Chest
Bar Sink RPZ Valve
Comm Ice Maker
Dishwasher Breakrm Sink Bidet
Int Grease Trap
Floor Drain Classrm Sink Urinal
Hose Bibb Exam Sink Ext Grease Trap
Beer Tap Eye Wash Stn
Water Heater \ F Prep Sink Dipper Well
Gas❑Elect 0 PwrVnt Deduct Meter
Floor Sink Drink Fntn
Clothes Wshr Wtr Sewer Mtr
Hand Sink Wash Fntn
Lndry Tray Lab Sink Wtr Usage Mtr
Catch Basin Misc Fixtures
Electric Contractor (for projects not requiring an EIV Form)
Use/Nature of Work ' .„„<;a \\ y. .Nic \i\tt, %c
Size Material Type #
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
06/09