HomeMy WebLinkAbout0154607 - Plumbing 9water heate) CITY OF OSHKOSH No 154607
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1495 W SOUTH PARK AVE Owner NOR-AM INC _ Create Date 03/04/2013
Contractor GARTMAN MECHANICAL SERVICES Category 443-Commercial-Interior(Replacement Fixture 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 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 (COMM(AMERICINN)/REPLACE POWER VENT WATER HEATER, EIV SIGNED BY WITZKE ELECTRIC **debit 7
of Work acct
Size Material Type # Conn.Type
1 Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1307440200
Valuation $8,630.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided j
-
Issued By . ( i .' Date 03/04/2013
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 520 W SOUTH PARK AVE OSHKOSH WI 54902 -6470 Telephone Number 920-231-5530
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.
Mar. 4. 2013 11 : 16AM GMS INC No, 3635 P. 1
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh,WI 54903-1130
@-
Phone:(920)236-5050
Fax:(920)236-5084 O �_ ��/ {
t u\OI 1
Plumbing Permit Application ON TFlF wares
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described,the work to confoim 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 5100.00 plus the normal permit fee,which
ever is greater.
. OR
-�- —� I 'ware a ontre_ or • ici'ati,. th 1 Perm'l ee � ount tern and h
ifvou-tivani thi's aressed•ihrn_: • 'our-a cm: -Q--- -••- -.- - - --_- - _-- -Ye ad --. ands the k here
**Advisory-For applicable projects, an Electrical Installation Verification -_ . _
Contractor or Homeowner(for installations allowed to be performed by the homeowner)mast be submitted cal
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,
3 ' �Job Address L'/' W.Sv r k Value(Including labor any materials) a Q Date 3�y i
Owner .
Av rt er h„-% 147/4 4...I Contractor _ & c-
i
S n
Osingie Family []Duplex ['Multi-Family ['Rental
[}e6mmerci$1 ElIndastrial
Number of Fixtures: •
B+tht,.h Disposal Ftp
p0ol Dishwasher
Wait.St Catch Basin
Lavatory Sump Pump Wash F�
Lavatory Ice Chest Urinal
Isle etor/Griad Exam Sink
Res Sink Water SoRner am Drain
Bar Sink Loral Wesee SAY S Soda Diap
Band Sink
Water Beater -!�� GoffeeMaka
0 Gas fJ B1ect fM�vrV, Clothes Wslir F Prep Sink
Comm ice Maker
Shower Bidet 5ary Sink SltdDram
Beer Tap let Grease Trap
Roof Drain I IoorDraB
Classmu Sink Ezt Gress Trap Stan
Lathy Trey dp Rec
Lab Sink
Surgeons Sink RPZ Valve Bye Bra Sink wee,sm
Plaster Sink Sbamp Sink Wtr Sewer Mtn
Sterilizer Dip Well Flr/Wst Sink
Deduct Meters
HoseBibs
Misc. WI Usage Mar
Fixlrnes
Electric Contractor(for projects not requiring an EIV Form) C&2.-1-z.4 b(e_a&-,
Use/Nature of Work .-.
Size Material 1pe
Conn.Type
Sanitary Sewer ,
Storm Sewer
Water-Service j'
Received Time Mar. 4. 2013 11 : 11AM No, 2474 owo7
Mar. 4. 2013 11 : 16AMi GMS INC ELECTRIC NNo. 3635 PP. 2
., f e 3 ,x• 13
City o0Oe11104s.
Division oalas:pee=an Services
215 Chula Avenue
PO Boo 1130
Ochkooh WI 54903.1130
l (YdT�12 Olen 020436-SO50
N �920.236-50E4
Electric Installation Verification
I(We) ' / . _ 1' i 1 r
(Electrical Contractor Name or Homeowner's Name)
/5 .roi - - D • 5 !
(Address) (City) (State) (Zip Code)
accept the responsibility to perform the electric work as stated below, at the following address:
J e�/,C�Jam' r- - 7ei 24.-r 7"�.v , ik �c iC.ihA . ne;4,
r b��-- (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 Renting Plant and/or A/C Condenser,
r Reconnection or new circuit for replacement Electric,Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable,Meter Sox, alterations to receptacles
and lighting Sxtures 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, including
required service electrical outlets. Note: Homeowners can only do their own
electric on a single family owner occupied home. Work on a condominium,
duplex rental, or multi-use building would require a licensed Electrical
Contractor.
Other
The value of this work is S__,/,.5__•L_____.
I hereby verify this work will be performed in compliance with the License requirements of
Section 11-22 of the Oshkosh Municipal code and further verify the reconnection/installation
will be done in compliance with manufacturer and Electric code requirements.
.1.1c,..yr‘ cs).....cA
TM 6Lic 3 • y- /3
(Signets=or Company Officer or Hawn meoer) (P=int Name) (Date)
Received Time Mar. 4. 2013 11 : 11AM No. 2474 07107