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Home My WebLink About0152150 - Plumbing (water heater) CITY OF OSHKOSH No 152150 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER KOELLER ONE LLC Create Date 09/05/2012 Owner Job Address 1020-1142 S KOELLER ST -- - - Category 446 Commercial-Water Heaters Plan Contractor WATTERS PLUMBING --- -- - ---_ Inspector Jerry Fabisch --_--_ __ --- Deduct Meters Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain - - Wtr Sewer Mtrs Soda Disp Tray Exam Sink Sterilizer P --- Shower Lndry Y Coffee Maker Wtr Usage Mtrs F Prep Sink RPZ Valve -- Whirlpool Sump Pump _ P —— ---- Site Drain Misc. Lavatory San Sump/Pump FIrIWst Sink Bidet - _ Fixtures Toilet Water Softner Hand Sink Urinal Wait.St. --- Kit Sink Standp Rec Lab Sink Beer Tap Ice Chest Comm Ice Maker Plaster Sink Dip Well --- Disposal Gar Drain ----- Sculry Sink Drink Ftn Int Grease Trap Dishwasher Local Waste rY --- 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 COMM I (CHINE ONE RESTAURANT-1138 S KOELLER)/REPLACE ELECTRIC WATER HEATER,EIV SIGNED BY'i of Work BELL ELECTRIC **debit acct I J Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# 1308490000 Valuation $900.00 \ Plan Approval _-_ -_ $0.00 Permit Fees $25.00 Permit Voided I Date 09/05/2012 Issued By , 5-)7.'Y.--) 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. Date Signature Agent/Owner Address PO BOX 118 _ _ MENASHA WI 54952_ -0118 Telephone Number 920-733-8125 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. Z001/002 9/05/2012 WED 11: 10 FAX 920 733 2713 Watters Plumbing City of Oshkosh Inspection Services Division 9 pOBos1130 (--11111111* Oshkosh,W) 4903-10 30 Ph 2 -_( (�? O.IHKIH Phone:(920)236-5050 Fax'(920)236 5084 ov THE WATER . Plumbing Permit Application 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, • 54903 1128. and fee(s)can be brought ithouto ermit(s)lwilloresult in fees being tdoubledtorr$11 00 plus the normal permit fee,which 54903-1128. Commencing work permit(s) is greater. OR (f you are a Contractor Uarticia tin-�n the Fermi;Fee Account S stem and have adequate funds, check here i ou want this ,rocessed t ** For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical Advisory- pp p Contractor or Homeowner(for installations t�mwtted to�performed� Wthe��is required, ill not submitted with the permit application. Applications processed for Permit Issuance and w'will be returned for completion. - () r, Z, y/ F (Including ��I) Date f-'f Job Address (. Value Including labor and materials)_ Owner (. '\‘1■ A (M.Ck R Pelt{UPC ontractor ['Single Family ❑Duplex ❑Multi-Family ❑ Rental 0,Commercial ❑Industrial Number of Fixtures: Roof Drain Sump Pump Plaster Sink Bathtub Soda Disp San.Sump/Pump Scullery Sink Shower Coffee Mkt Water Softener Service Sink Whirlpool Site Drain Standpipe Rec Shamp Sink Lavatory Toilet Waitrs Stn Garage FD Surgeons Sink oilet Ice Chest Local Waste Sterilizer Kit Sink ____ Comm Ice Maker Bar Sink Rl'Z Valve _ Disposal __.— -"'--" Int Grease Trap Break Sink Bidet FloorDrain Urinal Ext.Grease Trap Floor Drain Classmi Sink Hose Bibb Exam Sink ---- Beer Tap Fye Wadi Stn i' Dipper Well Deduct Meter F Prep Sink Water ea r Drink Fntn Wtr Sewer Mtr LI Gas •feet U PwrVnt Floor Sink Wtr Usage Mtr _--Wash Fntn Clothes Wshr _ Hand Sink Nike Fixtures __ Lndry Tray _ Lab Sink Catch Basin Electric Contractor(for projects not requiting an EIV Form) Use 1 Nature of Work # Conn.Type Size Material Type Sanitary Sewer Storm Sewer Water Service ---- 06/09 Received Time Sep. 5. 2012 11 : 04AM No. 0726 09/05/2012 WED 11: 10 FAX 920 733 2713 Watters Plumbing 0002/002 C 920-236 -5(384 p. 1 CO ioOshkosh 215 Chu of Inspection Services 215 of Osh Avcrnm PO Dos 1130 _ Oshkosh WI 5A003-1130 1._g 7T-—I Oflicc 920.623-5601 0 ._. �/ /j�\/''y ou IMt WnICA' Fax 930-236-SORA (..-'. 2. / l- V- Electric installation Verification <`"> (Electrical Contractor Name) y5 1_7Z.LG1�. �;/i — (State) (Zip Corte) (Address) �/ (City) have been contracted to perform electric installation work:for I &A_ G '1 .S (Name of party contracted to) at the following address: ---_.-/.�[? J• /�-� `-� I � �Y (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. L 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(house or the individual systems in a duplex or condominium;.,including required service electrical outlets. Other. The value of this work is $ ~ I hereby verify this work will be performed by an employee of this company and further verify the reconnection/installation will be done in compliance with manufacturer and Electric code requirements. Cm (Signature of Company Officer) (print.Name of Officer) (Date) 5/02 Received Time Sep. 5. 2012 11 : 04AM No. 0726