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Home My WebLink About0153210 - Plumbing (pwr vent wter heater) CITY OF OSHKOSH No 153210 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 1995 HICKORY LN Owner DAVID M/BARBARAANGELL REV TRUST Create Date 10/26/2012 Contractor D R GLAZE PLUMBING 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 FIrlWst 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 SFR/REPLACE 50 GALLON POWER VENT WATER HEATER **check#1193 - of Work Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# 1526140000 Valuation $1,500.00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided j Issued By (,,(, Date 10/26/2012 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 1865 JAMES RD OSHKOSH WI 54904 -6873 Telephone Number 920-589-4014 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 41/.ir in3 P O Box 1130 Oshkosh, WI 54903-1130 Iis'v Phone:(920)236-5050 1017C1 k,- Fax:(920)236-5084 0/HKOfH Plumbing Permit Application ON THE WATFR 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 **Advisory-For applicable projects, an Electrical Installation Verification Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be by the El submitted ectrical 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 MU ft< ory Loki Value(Including labor and materials) d Owner ( �SGD°O Date (>J� z htz-- Arrt Apt c.t Contractor �� Crc,Az- ( iAAIPAG Single Family ODuplex ❑Multi-Family DRental ❑Commercial ❑Industrial Number of Fixtures: Bathtub Sump Pump Plaster Sink Roof Drain Shower San.Sump/Pump Scullery Sink Soda Disp Whirlpool Water Softener Lavatory Service Sink Coffee Mkr Standpipe Rec Shamp Sink Toilet Site Drain Garage FD Surgeons Sink Kit Sink Local Waste Waitrs Stn Disposal Sterilizer Ice Chest 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 I F Prep Sink Dipper Well I 1 Gas CI Elect kir rwrVnt Fl Deduct Meter Floor Sink Drink Fntn Clothes Wshr Hand Sink Wtr Sewer Mtr Wash Fntn Wtr Usage Mtr Lndry Tray Lab Sink Catch Basin Misc Fixtures Electric Contractor(for projects not requiring an EIV Form) Use/Nature of Work 7 A..4<-;r --D jckl/ vJ /0 (-I Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service 06/09