HomeMy WebLinkAbout0100964-Plumbing (water heater) CITY OF OSHKOSH
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
JobAddress 33 EVELINE ST Owner MICHAEL/THERESA EIERMAN Create Date 04/24/2003
Contractor SOPER PLUMBING Category 411 - Residential-Water Heaters Plan
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 ServSink 0 Soda Disp
Lavatory 0 Lndry Tray 0 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker
Toilet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap __
Bar Sink 0 Dishwasher 0 BeerTap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 10096.4
Use/Nature SFPJReplace gas water heater
of Work
Sanitary Sewer
Storm Sewer
Water Service
ValuatiOnlssued By ;~~,.~ $4..00 P n Approval
Size Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$0.00 Permit Fees $20.00
[] Permit Voided
Date 04/24/2003
In the performan~hi,s wo~,_,~ree to perform all
S ig nat u r~_~~..,a..~ j~.,-"'""~
Address 2225 BURNWOOD DR
work pursuant to rules governing the described construction.
Date ~"~/'~;:~ ~
Agent/Owner
Oshkosh WI 54902 - 0000 Telephone Number 426-2151
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 Inspechon 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
(f you want this processed through Four account [-]
Job Address-.-~3 ~'UC'-~J,,-~~-' Value (Including labor and materials) ~S~O Date
Owner /7/'//A"~.~ · ~-.~7:,',~-,~ Contractor _~,~/~
~Single Family [~]Duplex [--]Multi-Family [---]Rental [--]Commercial [--]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink ·
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater / Local Waste Sculry Sink Soda Disp
,~l~Gas [3 Elect [3 PwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink lnt Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor
Use / Nature of Work
OR
Sanitary Sewer
Size
[~Elec'tric Installation Verification form attached
(If Replacement)
Material Type # Conn. Type
Storm Sewer
Water Service
3/02