HomeMy WebLinkAbout0100940-Plumbing (water heater)OSHKOSH
ON THE WATER
.lob Address 240 W 9TH AVE
Contractor GARTMAN MECHANICAL
Bathtub 0 Shower 0
Whirlpool 0 Floor Drain 0
Lavatory 0 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 0
Bar Sink 0 Dishwasher 0
Water Heater 1 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner PEACE LUTHERAN CHURCH
Category 441 - Industrial-Water Heaters
Ejector/Grind 0 DipWell 0 F Prep Sink 0
Water Softner 0 Drink Ftn 0 Serv Sink 0
LocaIWaste 0 Wait. St. 0 Shamp Sink 0
CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Bidet 0 Exam Sink 0 Catch Basin 0
Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Dent. Oper. 0 Hand Sink 0 Urinal 0
Lab Sink 0 Plaster Sink 0 Standp Rec 0
Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100940
Create Date 04/23/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature
of Work
Lutheran/Install gas water heater.
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$3,780.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date
04/23/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 520W SOUTH PARKAV OSHKOSH WI 54902 - 0000 Telephone Number
920-231-5530
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
ON /HE 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, 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 Perrni, t~Fee Account System and have adequate funds, check here
if you want this processed through your account ~
Job Address 19 4I~ ,~__,~_3 ~ Value (Including labor and materials). }3~, ~(~ ~- Date ~
Owner "~{, ~>
q ~v.._. ~..~' ~ L.~-~ XA/~. ('~J'h Contractor
["-]Single Family [--]Duplex ['-]Multi-Family ['-]Rental ~Commereial [-]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater j Local Waste Sculry Sink Soda Disp
~Gas Clothes Wshr Hand Sink Coffee Maker
Elect
PwrVnI
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Sctv Sink Site Drain
Lndry Tray Classrm Sink Int Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
["-]Electric Installfition Verificatidn form attached
(If Replacement)
Use / Nature of Work
Sanitary Sewer
Storm Sewer
Water Service
Size
Material Type # Conn. Type
3/02