HomeMy WebLinkAbout0152722 - Plumbing (replace power vent water heater) CITY OF OSHKOSH No 152722
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 215 N WESTFIELD ST _ Owner GABRIELS VILLA INC Create Date 10/03/2012
Contractor APPLE CREEK 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 FIr/Wst Sink Bidet Site Drain Misc.
- - - – Fixtures
Toilet Water Softner Hand Sink Urinal Wait.St.
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 POWER VENT WATER HEATER **chekc#5472
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0611490000
Valuation $9,500.00 Plan Approval _ $0.00 Permit Fees $25.00 ❑ Permit Voided]
Issued By Eyntv Date 10/03/2012
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.
Date
Signature
Agent/Owner
Address 805 E APPLE CREEK RD APPLETON WI 54913 -8368 Telephone Number 920-731-7733
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
POBox 1130
Oshkosh,WI 54903-1130
Phone: (920)236-5050 KO1
Oft ��((� f
Fax: (920)236-5084 �,Jfi
ON 7-1r 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.
• Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,P()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
if you want this processed through your account 11
** Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
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. C] / q
S`1• Value(Including labor and materialsA4600.00 Date?/Z9/�C
Job Address 215 N• uie.stfzeI� g
Owner Ga6:el•s U l\k. Contractor lAIp)e_ Cr.«k- 1u+..'-1'
lex Multi-Family ❑Rental nCommercial Industrial
nSingle Family ❑Du P
Number of Fixtures:
Sump Pump Bathtub
Sum Pum 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 Sterilizer Ice Chest
Disposal
Bar Sink RPZ Valve Comm Ice Maker
Dishwasher
Breakrm Sink Bidet Int Grease Trap
Floor Drain
Classrm Sink Urinal Ext Grease Trap
Exam Sink Beer Tap Eye Wash Stn
Hose Bibb Deduct Meter
y F Prep Sink Dipper Well
Water Heater Wtr Sewer Mtr
X Gas J Elect Pwrvnt Floor Sink Drink Fntn
Clothes Wshr Hand Sink
Wash Fntn Wtr Usage Mtr
Lndry'fray 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
-609