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Home My WebLink About0152971 - Plumbing (water heater) Ci) CITY OF OSHKOSH No 152971 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 1656 HUNTERS GLEN DR Owner STUART/DEBORAH CHALLONER Create Date 10/16/2012 Contractor HOMEOWNER _Category 411 -Residential-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 FIrIWst 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 GreaseTrap _ 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 SFR/Installation of a new water heater. of Work Size Material Type # Conn.Type Storm Water Parcel Id# 1331760000 Valuation _ $500+0 Plan Approval $0.00 Permit Fees $25.00 11] Permit Voided Issued By ., •,A e e � Date 10/16/2012 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 f this work, I agree to p rform all work pursuant to rules governing the described construction. / I Signature cu v� ,. °Y`�"'� Date`� 1o/ l(9/IQ Agent/Owner ( f Address 1656 HUNTERS GLEN DR OSHKOSH WI 54904 8965 Telephone Number 231-3940 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 P O Box 1130 Oshkosh, WI 54903-1130 Phone: (920)236-5050 Fax: (920)236-5084 Of HKcDJH Plumbing Permit Application ON THE WATER 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 Permit Fee Account System and have adequate funds, check here if you want this processed through your account n **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. Job Address )(D`S() AL,_h-i V C r . Value(Including labor and materials) 5-OO. C l Date 1 /1 Owner Owner J-t ;.v4 Ckc,1 t ' v" Contractor ,Single Family ❑Duplex ❑Multi-Family ❑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 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 Hose Bibb Exam Sink Beer Tap Eye Wash Stn Water Heater X F Prep Sink Dipper Well Deduct Meter ❑Gas❑Elect lR PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr Clothes Wshr Hand Sink Lndry Tray Wash Fntn Wtr Usage Mtr ry y 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