HomeMy WebLinkAbout2013-Plumbing (water heater) CITY OF OSHKOSH No 155241
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1305 WITZELAVE Owner GUILLERMO E CONTRERAS Create Date 04/24/2013
Contractor JOHN D RANSOM Category 411 -Residential-Water H ea ters 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#1871
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0608640000
Valuation x$630.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided
(JiIssued By K k.J Date 04/24/2013
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.
i Storm Sewer I
1
i Water Service
RECEIVED
City of Oshkosh °°11111--
Inspection Services Division
PO Box 1130 APR 242013
Oshkosh. WI 54903-1130
Phone: 920 236-5050 011 l<0./1-1
t � DEPARTMENT OF
Fax: (920)236-5084 COMMUNITY DEVELOPMENT
INSPECTiO EP GCFS DIVISION ON THE WATER
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 peintit(s)will result in fees being doubled or 5100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit Fee Account System and have adeauate funds, check here
if you want this processed through your account n
Job Address 130 S w ( 1 2-e-1 rl 'E- Value(Including labor and materials) 6 3 0 r� Date �l cZ0'13
Owner CIV11-er Co Y -rte r-c.s Contractor 37.AN� ctinsor►-N _
[Single Family E 'Duplex I 'Multi-Family FIRental Commercial ( (Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent.Oper. Shame Sink
Whirlpool Disposal Dip Well FlrIWst Sink
Lavatory Dishwasher Drink Ftn Catch Basin ____
Toilet Sump Pump Wait.St. Wash Fm
Res.Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater )1." Local Waste Sculry Sink Soda Disp
XGas C Elect li PwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Dram Beer Tap Sery Sink Site Drain
Lndry Tray Class=Sink Int Grease Trap Roof Drain
Lab Sink - Surgeons Sink Ext Grease Trap Standp Rec ____..
Plaster Sink Breakup Sink
Sterilizer
Electric Contractor OR I 'Electric Installation Verification form attached
(If Replacement)
Use. / Nature of Work re p\GCe 6D,,,$ uVat e r hprAter
Size Material Type 4 Conn.Type
Sanitary Sewer
Storm Sewer
{ Water Service
/C