HomeMy WebLinkAbout0154178 - Plumbing (water heater) CITY OF OSHKOSH No 154178
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 541 MONROE ST Owner EDWARD C/DIANNE J WILCOX Create Date 01/16/2013
Contractor JOHN D RANSOM Category 411 -Residential-Water Heaters Plan
Inspector Jon Mueller
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 FIr/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 DUPLEX/REPLACE GAS WATER HEATER **debit Kitz&Pfeil acct
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0404780000
Valuation _ $599.00 Plan Approval $0.00 Permit Fees _ $30.00 ❑ Permit Voided
Issued By 5-"Yr-0--- Date 01/16/2013
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 W5056 PARADISE LN FOND DU LAC WI 54935 -9662 Telephone Number 920-922-1987
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.
iliUE, JAN. 15, 2013 12: 58 PM KITZ&PFEIL OSHKOSH FAX No, 920 236 3348 P. 001/001
City of Oshkosh
Inspection Services Division
P 0 Box 1130
0 •
Oshkosh,WI 54903-1130
Phone:(920)236-5050
•
Pax:(920)236-50840_/H1
Plumbing Permit Application ON T" ATEa
I hereby apply for a permit to do and install the following plumbing on the promises 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,FO 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 particitaatinz in the ?gr nit Fee Account System and have adequate funds. check here
if you wart this proces;e�through your account n
•**Advisory-For applicable projects, an Electrical Installation Verification r
(ETV)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.
qlJob Address m `L (2�/ +-hroe yr Value oncluding labor and mgerials) �/ ! Date I—/ 2-49/.9
Owner -iL-ci IA), i GO 5C Contractor ti / /!f0/h . _
❑Single Family ` ]Duplex DMulti-Family DRental ❑Commercial
•
DIndastria]
Number of Fixtures: .
•
Bathtub Sump Pump Plaster Sink Roof Drain
Shower • San.Sump/Pump Scullery Sink • Soda Disp
Whirlpool Water Softener Service Sink Coffee Mla •
Lavatory Standpipe Rec Stump 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 Breakrm Sink get Sot Grease Trap
Floor Drain Class=Sink • • Urinal • Ext Grease Trap
Hose Bibb • Exam Sink Beer Tap • Eye Wash Stn
Water Heater P Prep Sink Dipper Well Deduct Meter
tGas C Elect 0 PwrVnt Floor Sink Drink Pnm Wtr Sewer Mir
Clothes Wsht Hand Sink Wash Pntn Wn Usage Mir
Lndty.Tray Lab Sink
Catch Basin Mist Fixtures
•
•
•
Electric Contractor (for projects not requiring an EIV Form) .
' Use/Nature of Work te.p�4c� q aS W gv hea+e
Size (j Material Type # Conn,Type
** ***********
Please use
Sanitary Sewer the
Storm Sewer Fitz & Pfeil
Acct
Water Service 'hank you,
. Chris
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•
•
06/09 •
Received Time Jan, 15. • 2013 11 :48AM No. 2093 •