HomeMy WebLinkAbout0154023 - Plumbing (power vent) CITY OF OSHKOSH No 154023
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1025 E IRVING AVE Owner CHARLES F RUSSELL Create Date 12/21/2012
Contractor WATTERS PLUMBING Category 411 -Residential-Water Heaters Plan
Inspector Jerry Fabisch
Bathtub 0 Clothes Wshr 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower 0 Lndry Tray 0 Exam Sink 0 Sterilizer 0 Soda Disp 0 Wtr Sewer Mtrs 0
Whirlpool 0 Sump Pump 0 F Prep Sink 0 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. 0 Fixtures
Kit Sink 0 Standp Rec 0 Lab Sink 0 Beer Tap 0 Ice Chest 0
Disposal 0 Gar Drain 0 Plaster Sink 0 Dip Well 0 Comm Ice Maker 0
Dishwasher 0 Local Waste 0 Sculry Sink 0 Drink Ftn 0 Int Grease Trap 0
Floor Drain 0 Bar Sink 0 Sery Sink 0 Wash Ftn 0 Ext Grease Trap 0
Hose Bibb 0 Breakrm Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 1
Use/Nature SFR/REPLACE POWER VENT WATER HEATER **debit acct
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1104320000
Valuation �%/ )x$1,50 .00 Plan Approval $0.00 Permit Fees $25.00 ❑ Permit Voided
(53 '
Issued By '( Date 12/21/2012
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.
12/21/2012 FRI 13: 39 FAx 920 733 2713 watters Plumbing 0001/001
City of Oshkosh
Inspection Services Division
P O Box 1130
414DIF'
Oshkosh,WI 54903-1130 r- i
Phone:(920)236-5050 12 (41 14 OIHKOJH
Pax:(920)236-5084 11
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. ee Account System and have adequate funds, check here
if you want this processed throuEh your account
**Advisory-For applicable projects, an EIectrical 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. U
Job Address f , ifp��i )f�" A . Value(Including labor and materials) IS/S-06/ ZO iy-p(ix• Date /Z 21---/2_
Ow er C h,If ik e, ;k i S '1.'_ Contractor __A,__WC; 7 H ►Single Family ❑Duplex ❑Multi-Family ❑Rental ommercial ❑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 Rae Shamp Sink Site Drain
Toilet Garago FD Surgeons Sink __ Waitrs Stn
Kit.Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve .,_ _ Comm Ice Maker
Dishwasher Break=Sink - Bidet Int Grease Trap
Floor Drain Class=Sink Urinal Ext Grease Trap ___
Hose Bibb Exam Sink Beer Tap Eye Wash Sul
Water Heater F Prep Sink —'— Dipper Well Deduct Meter
U Gas Ll Elect PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clothes Wshr Hand Sink 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
Size Material Type II Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
nb/09
Received Time Dec, 21. 2012 1 : 33PM No, 1977