HomeMy WebLinkAbout0154558 - Plumbing (pwr vent water heater) CITY OF OSHKOSH No 154558
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2045 HICKORY LN Owner AHMAD Y/LINAH R HAFFAR Create Date 02/26/2013
Contractor M P KELLY 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 FIrIWst Sink 0 Bidet 0 Site Drain 0 Misc. 0
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. o 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, EIV SIGNED BY T RUCK ELECTRIC "check#12578
of Work
Size Material Type # Conn.Type
Sanitary Sewer
•
Storm Sewer
Water Service
Parcel Id#
1526170000
Valuation $1,47C.00 Plan Approval _ $0.00 Permit Fees $30.00 ❑ Permit Voided)
Issued By (^. Date 02/26/2013
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 665 N MAIN ST OSHKOSH WI 54901 -4431 Telephone Number 231-1750
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.
VCI.. IJ. GV11 IV.Junin v i I I Ill vv n..vv it 411.3. ..vi 4.311 '•-. • • --
City of Oshkosh
Inspection Services Division
PO Dolt lI30
Oshkosh,WI 54903-1130 , ®
Phone:(920)236-5050 .Td _, "mod
pax:(920)236-5084 11J�1 �J
is ^h a
Plumbing Permit Application
I hereby apply for a pennit 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 statute&
• Applicetion(s)and fbe.(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI
54903-1128. Commencing work without permits)will result in fees being doubled or$100.00 plus the normal permit fee,which
ever is greater. •OR,-re'a c,,, ra i s e r;u a s:t-i, , h, ate fun' s. c&eck here
if you wart this pr.ocesrand through your Account. C`1
**Advisory-For applicable projects, an Electrical Installation Verification(F IV)form,signed by the Elm:Weak
Contractor or Homeowner(far installations allowed to be perforated by the homeowner)must be submitted
with the permit application. Applications submitted without pnV when such is required,will not be
processed for Pewit Issuance'and ill be returned for completion, CO Job Addreae
/ii' 4( ne ding labor and materials) ./ 97o ' i Date /5-
Q•. •e>r /11144-11-./ __ flIFI/ Confractor ., --;-
trI ,' .Family linuplex (]Multi-Family []Rental OCommercial ■Industrial
Number of Fixtures:
Bathtub Sump Pump ,- -_.,_- Plaster Sink RuofDmin --
Shower , San.Sump/Po mp Sculley Sink Soda Ditp 4
Whirlpool Water Softener Service Sink Coe'Mkr
Lavatory Standpipe Rtc Stamp Sink Site Drain
Toilet Garage FD Surgeons Sink GVaitrs Sin
Kit Sink Local Waste Sterilizer Ice Cheat
Disposal _ Bar Sink RPZ Valve Comm lee Maker
Dishwasher Brcaktm Sink 'Bidet Int Grease'hip
Floor Drain Classrm Sink _,___,— Urinal Ext Grease?rap
Hose Bibb Bum Sink Beer Tap Eye Wash Sin
Water Heater P Prep Sink Dipper Well Deduct Meter
Q Oar 0 Rleat nt Floor Sink Drink Fntn Wtr Sewer Mk
Ctothea Wshr _ Hand Sink Wash Pntn Wtr Usage Mtr
Ln&yTiftY Lab Sink Catch Basin Mire PixWtw
,. mg -nE1VF.
lectric Contractor(for p oleos not X u og ) if.)t /
me/Nature of Work Ar / 44 '
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer '-';' CO
Water Service / _.; Li
ervice V •
06/09
City of Oshkosh
Division of Inspection Services
215 Church Avenue '
PO Box 1130
Oshkosh WI 54903-1130
Office 920-236-5050
ON-iN wnre Fax 920-236-5084
Electric Installation Verification
s
I(We) �// ��.� •
•
(Electrical Contractor Name)
690 A), D4/1, Z4 /,€) Yqo/ - -
(Address) (City) (State). (Zip Code)
have been contracted to perform electric installation work for \v/ (_- ' L Iii" -'
(Name of p contracted to)
�at the following address: 6 Vs J7'i e/ca , C ,
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or A/C Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable,Meter Box,alterations to receptacles
and lighting fixtures due to siding/soffit installation: Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances/ fixtures.
New circuit for the addition of A/C to an individual dwelling unit(house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $% ''
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection/installation will be done in compliance with manufacturer and Electric code
requirements.
IL Of
d
(Signature of Company Officer) (Print Nam of Off)er) ( ate)
5/02