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Home My WebLink About0153162 - Plumbing (water heater) CITY OF OSHKOSH No 153162 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 411 419 S WESTHAVEN DR Owner COUNTRY PARK LLC APARTMENTS Create Date 10/24/2012 Contractor WATTERS PLUMBING 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 COM\Replace NG wawter heater of Work Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# 0614900000 Valuation $1,10000 Plan Approval –___ $0.00 Permit Fees $25.00 ❑ Permit Voided' Issued By 41:06�� — Date 10/24/2012 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. Signature Date 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. 0/24/2012 WED 9: 08 FAX 920 733 2713 Watters Plumbing U001/001 City of Oshkosh Inspection Services Division P O Box 1130 Oshkosh,WI 54903-1130 4011111/1P9 Phone:(920)236-5050 /n Fax:(920)236-5084 ; 1 '2 -2--e)(' () QJHKOJH ON 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. • 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 Perm't ee Account System and have adequate funds, check here if you want this processed through your account. **Advisory-For applicable projects, an Electrical Installation Verification(ETV)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. t,"i Job Address i? S- u k s-}-H uQ J J Value(Including labor and materials) / DU . Date / 2 • ./2- Owner RAt, +W)Od /4 Contractor U_17.71- ./l.S Ph)✓�&n6- ❑Single Family ❑Duplex Multi-Famil Rental c-6-FAr�t� ❑ ❑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 Roe Sham Sink Shamp 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 Breakmt Sink Bidet Int Grease Trap Floor Drain —_— Classtm Sink __ Urinal Ext Grease Trap Hose Bibb Exam Sink Beer Tap — Eye Wash Stn �" Water Beater F Piep Sink Dipper Well Deduct Meter -- Gas U Elect U PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr Clothes Wshr Rand Sink --Lnd Tray Wash Fntu Wtr Usage Mtr __ Lndry y Lab Sink Catch Basin Misc Fixtures Electric Contractor(for projects not requiring an EIV Form) Use/Nature of Work Size Material Type 4# Conn. Type Sanitary Sewer Storm Sewer. Water Service 06/09 Received Time Oct. 24. 2012 9: 02AM No. 1377 10/23/2012 TUE 16: 22 FAX 920 733 2713 Watters Plumbing 2002/002 City ofOshkosh Division of Inspection Services 215 Church Amine PO Box 1130 Oshkosh WI 549034130 OfHKOJH Woe 020-236-5050 tNi ini wn�Crt Fax 920-216-5054 {z 6(z o Electric Installation Verification 1(We) ec-i-g� • (Electrical Contractor Name) 3o3 N. t o(,Ua n- YenAcW m Cu 6 Y9s z (Address) ) (City) (State) (Zip Code) �,Au.Q) Lv oo0 ble§-,4'have been contracted to perform electric installation work for i �] (Name of party contracted to) at the following address: 41 Q l S • 1 �I` � -' ` 1. (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. '?C 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 S .D i 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. --(04ALL` C. 1,;(_ t t_rD ( ign•ture o Company Officer) (Print Name of Officer) (Date) 5/02 Received Time Oct. 23. 2012 4: 16PM No. 1371