HomeMy WebLinkAbout0100965 Plumbing (water heater)OSHKOSH
ON THE WATER
JobAddress 1016 N LARK ST
Contractor GARTMAN MECHANICAL
Bathtub 0 Shower
Whirlpool 0 Floor Drain
Lavatory 0 Lndry Tray
Toilet 0 Lndry Stndp
Res. Sink 0 Disposal
Bar Sink 0 Dishwasher
Water Heater 1 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner OSHKOSH HOUSING AUTHORITY
Category 411 - Residential-Water Heaters
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
0 WaterSoftner 0 Drink Ftn 0 ServSink 0
0 Local Waste 0 Wait. St. 0 ShampSink 0
0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
0 Bidet 0 Exam Sink 0 Catch Basin 0
0 Beer Tap 0 SculrySink 0 Wash Ftn 0
0 Dent. Oper. 0 Hand Sink 0 Urinal 0
0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 100965
Create Date 04/24/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Repalce gaswater heater
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$525.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$0.00
Date
04/24/2003
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 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 participatD, g in the Permit Fee Account System and have adequate funds, check here
(f ¥ou want this processed through your account n
Job Address ~('li'~e I'X~ '~"%~\ ~
'X~Single Family ]--IDuplex
\
Number of Fixtures:
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
'"~as [] Elect [3 PwrVnt
Shower
Flea:' ~,rain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Value (Including labor apd mat;rials) .~i~', OO
Contractor ~},J<~[~{~,/~
Multi-Family r-]Rental r-]Commercial
Lndry'gt~fidp' ........................ Dent. Oper.
Disposal Dip Well
Dishwasher Drink Ftn
Sump Pump Wait. St.
Ejector/Grind Ice Chest
Water Sofmer Exam Sink
Local Waste Sculry Sink
Clothes Wshr Hand Sink
Bidet F Prep Sink
Beer Tap Serv Sink
Classrm Sink Iht Grease Trap
Surgeons Sink Ext Grease Trap
Breakrm Sink
Date~ lIaP- t S'}i~
[-]Industrial
Shamp Sink
Flr/Wst Sink
Catch Basin
Wash Ftn
Urinal ,~ .
Gar Drain
Soda Disp
Coffee Maker
Ice Maker
Site Drain
Roof Drain
Standp Rec
Electric Contractor
Use /Nature of Work ,),
Sanitary Sewer
Storm Sewer
Size
Material
O-R
Water Service
[~]Electric Install~i'tion Verificatidn form attached
(If Replacement)
Type # Conn. Type
3/02