HomeMy WebLinkAbout0155160 - Plumbing (water heater) CITY OF OSHKOSH No 155160
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1910 EVANS ST Owner CHARLES A/MARILYN J PERRY Create Date 04/19/2.013
Contractor KOCH PLUMBING&HEATING INC Category 446-Commercial-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 MULTI-FAMILY(1905 GROVE ST APT#4)/REPLACE GAS WATER HEATER **debit acct
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1514819706
Valuation $670.00 Plan Approval _ $0.00 Permit Fees $30.00 ❑ Permit Voided
5�Issued By n Date 04/19/2013
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 2005 DOTY ST OSHKOSH WI 54902 -7040 Telephone Number 920-231-6661 or 235
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.
This installation is complete and may be inspected at any time.
/C06/09 2 ... .-- t �7 06/09
City Oshkosh
Inspection Services Division
P O Box 1130
\*---,0 .
Oshkosh,WI 54903-1130
Fax (920)(9 20) 236-5050 Old-KOJl--
Fax. (920) 236-5084
ON THE WATFR
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 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
If vow are a contractor participating in the Permit Fee Account System and have adequate funds. check here
if you want this processed through your account Ni
**Advisory-For applicable projects,an Electrical Installation Verification(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 EN when such is required, will not be
processed for Permit Issuance and will be returned for completion.
Job Address //at-a2.:�y 57. Value (Including labor and materials) t0 ZC/ f Date 4-/ -
Owner 61,467,e'>'l.,n 7::1i / Contractor ,e x/ /6 .
❑Single Family ❑Duplex [Multi-Family [}Rental ['Commercial ['Industrial
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Dain
Shower San.Sump/Pump Scullery Sink Soda Disp
Whirlpool Water Softener Service Sink Coffee Mkr
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitis Stn
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher Breakrrn Sink Bidet Int Grease Trap
Floor Drain Classrm Sink - Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Stn
Water Heater / F Prep Sink Dipper Well Deduct Meter
Xas 0 Elect 0 PwrVnt Floor Sink Drink Fain Wtr Sewer Mm
Clothes Wshr Hand Sink Wash Fnm Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use I Nature of Work ir,C,eV .5. /f 7f s-- rfr.;:'= : :; -
Size Material Type # Conn.Type
Sanitary Sewer 5 4
Storm Sewer
Water Service
This installation is complete and may be inspected at any time.
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