The URL can be used to link to this page

Home My WebLink About0154039 - Plumbing (water heater) 0 CITY OF OSHKOSH No 154039 OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD ON THE WATER Job Address 103 W 15TH AVE Owner GERALD M/JILL L STANUCH Create Date 12/27/2012 Contractor OWNER 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/water heater installation***water heater installed without a permit late fee added"** Installing 40 gallon nat.gas of Work water heater. I l Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# 0304950000 Valuation $700.00 Plan Approval $0.00 Permit Fees $125.00 ❑ Permit Voided Issued By Date 12/31/2012 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 • s-cure ny necessary approvals before starting such activity. �n Signature - i Date ) 2— �f-!n�z_ Agent/Owner Address 103 W 15TH AVE OSHKOSH WI 54902 -6511 Telephone Number 920-233-0630 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. Lip Oshkosh Inspection Services Division ` PO Box 1 Oshkosh,WI 1 54903-1130 J Phone: (920)236-5050 Fax: (920)236-5084 OfHKOJH 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 Permit Fee Account System and have adequate funds, check here if you want this processed through your account fl **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. 7/� I 2 Job Address (0 3 V, f Ave Value(Including labor and materials) / l-� Date Z I Owner �1 e if ti Id .>+ "i G�� Contractor JSingle Family ['Duplex Contra( ❑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 Mk" 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 Breaknn Sink Bidet Int Grease Trap Floor Drain Classrm Sink Urinal Ext Grease Trap Hose Bibb Exam Sink Beer Tap Eye Wash Stn Water Heater 1 F Prep Sink Dipper Well Deduct Meter Gas 0 Electt]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) I Use/Nature of Work L/() ) l4 11 u b1i�l !i 4 eta Size Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service 06/09