HomeMy WebLinkAbout0155094 - Plumbing (water heater) CITY OF OSHKOSH No 155094
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1717 CLIFFVIEW DR Owner KENNETH UGLORIA J SPLITTGERBER Create Date 04/17/2013
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 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/REPLACE GAS WATER HEATER **check#12657
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1524720100
Valuation $1,8 .00 Plan Approval _$0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By Date 04/17/2013
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.
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City of Oshkosh ���y�I�i
Inspection Services Division
pO Box 1130
Oshlwah,WI 549034130 APR 17 2 013
fax:(920)(920)236-5050 ��1� 31�
fax:(920)236.5084
� • DEPARTMENT OF
Plumbing Permit Application CO�1`1L',tiTTll DEVELOPMENT
INSPECTION SERVICES DIVISION
I hereby apply for a permit too do and install the3bllow1ng plumbing on the promises hereinafter described,the work to'conform to the
Wisconsin State Plumbing Code,in the performance of which all perdu hereto agree to and are bound by said statutes.
• Application(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 permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which
ever is greater.
OR.
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**Advisory-For applicable projects, an Electrical Installation Yetri atton( form,signed by the Electrirai
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
with the permit application. Applications submitted without an E V when such is required,will not be
processed for Permit Issuance . . will be.r 1: ,ed for completion,
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Job Addr• ---1-/-4, fi (ncludingdabvrsnd materials) Dt
s , ,e, • i l i f ! / / Contractor R� i'
11 "gin Family r)upl f Mniti-Family Dgental OCommereial ■Industrial
Number of Fixtures:
Bal6tub
Sump.Pump Plaster Sink RoerDreln
Shower ,• Sari.Sume/Pump ScolitrySink _ Soda ilitp
Whirlpool Water Softener ServtceaSink Coftee•Mks
Lavatory Standpipe Rex Sbamp Slnk Site Drain
Toilet Garage FD Surgeons Sink Waihs Sin
Kit Sink Local Waste Sterilizer .�_-__ Tee Chest ---
Disposal , . Bar Sink RPZVelve Comm lee Maker
Breaktm Sink •Bidet Int Greur'tlap
Dishwasher Ext Grease Trap Floor Drain Chasm Sink —..
Exam Sink Beer Tap Eye Wash Stn
Hess Bibb T
P Prep Sink Dipper Well Deduct Meter Wert ..-.—
dElect l)PVrrVnt Floor Sink .Drdnk Fntn Sewer Mfr
Clothes Water Hand Sinn Wash Pntn Wtr Usk Mir
Lndry IV$Y Lab Sink Catch Basin Misc Fixtures -----
lectric CoUtirattor(for p
Jens loot. equ file Form)
le 1 Nature of Work AI ..1 / Vie' - dc _
Size Material Type # , Conn.Type
Sanitary Sewer
Storm Sewer ' •
Water Service (_____q0
06/09