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Home My WebLink About2012 - Plumbing (replace water heater) CDCITY OF OSHKOSH No 152565 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1432 W 3RD AVE Owner JEFFREY/PATRICIA KANNENBERG Create Date 09/17/2012 Contractor HOMEOWNER Category 411 -Residential-Water Heaters Inspector Jerry Fabisch - — Plan Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Tray — — Deduct Meters Shower Lndry y Exam Sink Sterilizer — ---- pool -- ---- Soda Disp Wtr Sewer Mtrs __ Whirl P Sump Pump F Prep Sink RPZ Valve Lavato - --- — Coffee Maker Wtr Usage Mtrs ry San Sump/Pump Flr/Wst Sink Bidet Site Drain Misc. Toilet Water Softner Hand Sink Urinal Fixtures Kit Sink Wait.St. 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 GreaseTrap Floor Drain Bar Sink Sery Sink _ Wash Ftn Ext Grease Trap Hose Bibb _ Breakrm Sink Shamp Sink Catch Basin Water Heater 1 — _--_ Eye Wash Statn Use/Nature SFR(LATE PERMIT)TREPLACE GAS WATER HEATER --- — ------ of Work Size Material Type # Conn.Type Storm Water — — — — Parcel Id# _ 0611820000 Valuation $475.00 Plan Approval — $0.00 Permit Fees $125.00 ❑ Permit Voided) Issued Byt\-/ Date 09/25/2012 The undersigned,in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the principle residence of the undersigned,hereby acknowledges,per Wisconsin State Statutes,ss 145.06,that other individuals will not be employed to assist with the work described by this permit. If an individual will be employed to install plumbing the work involved must be covered by a permit issued to a properly licensed Master Plumber. In the performance of this wo , I -.r=- to perform ally k pursuant to rules governing the described construction. Signature ±m �6 .. C �A �`�' Date r� Ag-,t/Owner Address 1432 W 3RD AVE OSHKOSH WI 54902 5604 Telephone Number 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. 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. City of Oshkosh Inspection Services Division Box 1 Oshkosh, WI 54903-1130 0 Phone: (920)236-5050 Fax: (920)236-5084 0/HKO/H Plumbing Permit Application ON THE�1ATER 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 I ou are a contractor •artici•atinf in the Permit Fee Account S stem and have ade•uate unds check here i ou want this processed through your account n **Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signeby the Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be 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/ /.-.501 /ic- �g Value (Including labor and materials) y - Date Owner -Nk /l iC/,t � T' Contractor Aildsingle Family ❑Duplex []Multi-Famil • y []Rental ❑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 Toilet Shamp Sink Site Drain Garage FD Surgeons Sink Kit Sink Local Waste Waitrs Stn Disposal Sterilizer Ice Chest Bar Sink RPZ Valve Dishwasher Breakrm Sink Comm Ice Maker Bidet Int Grease Trap Floor Drain Classrm Sink Urinal Ext Grease Trap Hose Bibb Exam Sink Beer Tap Water Heater X F Prep Sink Eye Wash Stn Gas p Elect 0 PwrVnt Dipper Well Deduct Meter Floor Sink Drink Fntn Clothes Wshr Hand Sink Wtr Sewer Mtr Lndry Tray Wash Fntn Wtr Usage Mtr Lab Sink Catch Basin Misc Fixtures Electric Contractor(for projects not requiring an EIV Form) Use/Nature of Work Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service 06/09