HomeMy WebLinkAbout0155266 - Plumbing (water heater) CITY OF OSHKOSH No 155266
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1555 SANDERS ST Owner GAIL M NOOYEN LIFE ESTATE Create Date 04/26/2013
Contractor JOHN D RANSOM 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#9566
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1305100000
Valuation $$7 .00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By Date 04/26/2013
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 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.
City of Oshkosh
® _-
Inspection Services Division
P 0 Box 1130
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax: (920) 236-5084 Off 1.<011 1
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 54903-1 128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the
normal peintit 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 i
Job Address /5-.5-5-- S p('s S4 Value(Including labor and materials) !,O Date /-03-(30 13
Owner 6-06 -)00 yen Contractor 'J 0\1 %-:-.. a(1So
['Single Family Duplex I 'Multi-Family I 'Rental I 'Commercial Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent.Oper_ Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink •
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump _ Wait.St. Wash Ftn
Res.Sink Ejector/Grind Ice Chest Urinal ___
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater Local Waste Sculry Sink Soda Disp ____
AGas E Elect YwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Sery Sink Site Drain
Lndry Tray Classrm Sink Int Grease Trap Roof Drain
Lab Sink Surgeons Sink - Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor OR I 'Electric Installation Verification form attached
(If Replacement)
Use l Nature of Work "ref 1kk-e 56( S .n)c,, Pr he(a ev
Size Material Type Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
3/02