HomeMy WebLinkAbout0155427-Plumbing (water heater) � CITY OF OSHKOSH No 155427
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1235 FAIRFAX ST Owner CLAYTON J/CAROL J THOSS Create Date 05/04/2013
Contractor RAUSCH PLUMBING 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
Whiripool 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 Serv 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 FR/REPLACE GAS WATER HEATER **check#27606
of Work I
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1342502300
Valuation $220.0 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided j
Issued By Date 05/04/2013
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
AgenUOwner
Address 1606 W HASKEL ST,STE A APPLETON WI 54914 -5032 Telephone Number 920-830-9222
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 af Oshkosh �
lnspection Services Divisiou �
P O Box l 130
Oshkosh,WI 54903-1 1 30
Phone: (920)236-5050 OJHKOlH
Fax: (920)236-5084
rN THF U/ATFR
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described,tlae work to conform to the
Wisconsin State Plumbing Code, in the perfor,nance of which all parties hereto agree to and are bound by said statutes.
• npplication(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services, PO Box l 128,Oshkosh WI
54903-I 128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which
ever is greater.
OR
� 1 � �ou ar e a conh acto� pa�ticipatinQ in the Pern:it Fee Account Svstem and have adequate_h�»ds cl�eck here
1�u u�ant this �r-ocessed lhrou�h vou�• acrount
** Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical
Co�;.ractor or Homeoss rier(for installations allowed to be performed by the homeowner)must Ue submitted
with the pennit application. Applications submitted without an EIV when such is requirec�, will not be
processed for Pernut Issuance and will be returned for completion.
i��
,Iob Adclress �n��'��/ �/il /S��L:_ VaIUC(Including labor and materials)�p7�U Date �
O���ncr (�� � i!�v SS Contractor /�iw 5�/ /�/� C
��ingle Family ❑Duplex ❑Mutti-Family ❑Rental ❑Commercial ❑Industrial
Numbcr of Fixtures:
�;�i���ii{� Swnp Pump _ Plaster Sink Konf Drain
Sho�ccr San.Sump/Pump _ Scullery Sink Soda Disp
�Vhirlpnol Watet Softenet
Service Sink Coffee Mkr
l.acatort Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink �Uaitrs Stn
� Kit Sink Local Waste Sterilizer Ice Chest
� Uisposal Bar Sink RPZ Valve Comm Ice Maker
Uish��asher Breakrm Sink Bidet Int Grease Trap
Floor Drain
Classrm Sink Urinal F,st Grease Trap
I lixc Ribb
Exam Sink E3eer Tap l�ye Wash Stn
� F Prep Sink Dipper Well Peduct Meter __
W�ter I leater _ ti�/tr Sewer Mtr
7�Z;as I)t:lect lJ Y�ti�rVnt Floor Sink Drink Fntn
Clothes\Vshr Hand Sink
Wash Fntn ���tr[Jsage Mtr
I.nJry"fray Lab Sink Catch Basin Misc Fixtures
i;lectric Contractor (for projects not requiring an EIV Form)
� � .�
Lise / Nature of Work 112�,nI�C,,� ���-i�,- <^�<--�z��
Size Material Type # Conn.
Sanitary Sewer �Ep,���;edE�S OF
C0�1�iU�ITY�EVEY.OP11 �tT
Storin Sewer INSPECTIO�SER�'LCES Dli' 10'�
Water Service
06/09