HomeMy WebLinkAbout0155578-Plumbing (water heater) � CITY OF OSHKOSH No 155578 .
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 807 HENNESSY ST Owner MR/MRS MICHAEL G RESTLE Create Date 05/10/2013
Contractor DRUCKS PLUMBING&HEATING CO INC Category 411 -Residential-Water Heaters Plan
Inspector Jerry Fabisch
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
Fioor 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/water heater replacement
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0617110000
Valuation $1,070.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I
Issued By ��-, Date 05/10/2013
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 314 APPLETON ST MENASHA WI 54952 -2318 Telephone Number 426-2654
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.
MAY-10-2013 12:43P FROM:DRUCKS PLUMBIN� C920)722-0651 T0:2365084 P.4
30
Ciry of Oslilcosh .
Inspection Serviccs Division � �
' P 0 Box 1130 �
� �� Oshkosh;WI 54903-1130
�'lione:(920)236-3050 • •
Fax:(920)236-5084
Plumbing Permit Application O H.W�rEA
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)cun bc brought to City Hall,Room 205 or moiicd to lnspcction Services,PO Box 1128,Oshkosh Wi
54903-1128. Commencing work without permit(s)will result in fees being doubled or S100.00 plus the normal permit fee,which
ever is greuter,
OR
1(vou nre a eon�ractor parffctpaling !n ehe Pernri� Fee Accor�nLSvslem and have adequate funds, check here
i[Yau wanl �his nrocessed �hroueh vour account (1
**Advisory-For applicable prajects, an Elecdrical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for installadons�llowed to be performed by the homcowner)runst be submittod
witli the permit appIicatioa. Applications snbsnitted withont an EIV when snch is reqnired, will not be
Qrocesscd for Permit Issuance aad will be Yetumed for compledon.
Job Address aa� f"le NN e SS ti VA�UC(lncluding lobor and rrmtuials) /O70 "� Date S ����3
Owner /'►�ltKe. ReS�F/e Contractor � e�e' (�,,.� s-k,
OSfngle FAmily ❑Daplex ❑Multi-Family ❑Rental ❑Commercial ❑In ustrial
Number of Fixtures:
Bethmb Sump Pump Plester Slnk Roof Dtain
Shower Sun.Sump/Pump Scullery Sink Sode Disp
Whirlpool Water SoRener 5ervice Sink CoRee Micr
Lavotory Stendpipe Rec Shnmp Sink Site Droin
Toilet Qarege FD Surgwns Sink Waitn Sm '
Kit Sink Local Waste Steriliur Ice Chest
Disposnl Bar Slnk RPZ Vn)ve Comm Ice Malcv
D'uhwasher Hrenkrm SinJc Bidet Int Grease Tnp
F'loor Dr�in Clnssrm Sink Urinnl Ext Grwe Trap
Hose Bibb Exam Sink Heer Tap Eye Wash Stn
Woter Heetcr �_ F Prep Sink Dipper Well peduet Metu
A��Ga+0 Elat 0 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr
Clo�he�Wshr Hand Sink Wesh Fnhi WvUmge Mtr
Lndry Tray Lab Slnk Cetch Dnsin Mlsc F1xUirw
� �
Electrlc Contractor (for projects not requiring an EN Form) .
Use/Nature of Work
Siz,e Material Type , # Conn.Type
Sanitnry Sewer � �
Storm Sewer
Water Service �
06/09