HomeMy WebLinkAbout0155632-Plumbing (water heater) � CITY OF OSHKOSH No 155632
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1005 BUCHANAN AVE Owner MARK S SMITH Create Date 05/14/2013
Contractor DRUCKS PLUMBING&HEATING CO INC 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 Urinai 0 Wait.St. � 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/REPLACE GAS WATER HEATER "debit acct
of Work
Size Material Type # Conn.Type
Sanitary Sewer '
Storm Sewer
Water Service
Parcel Id#
1607740000
Valuation $1,070.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I,
issued By �(,�f Date 05/14/2013
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 speci�ed 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.
Y-6-2013 07:52A FROM:DRUCKS PLl�1BING C920)72z-0651 T0:z365084 P.1
City of Oshkosh .
Inspection Services DivisIon � • �
' P 0 Box 1130 ' �
� Oshkosh.WJ54903-1130
�tione:(920)236-3050 -
Fax:(920)236-5084
� ON P.WATER
Plumbing Permit Application
I hereby epply for a permit to do and install the following plumbing on the premises h�reinaRer described,the work to conform to the
Wisconsin State Plumbing Code,in the performnnce of which all ps�rties hereto agree to and are bound by said statutes.
• Application(s)�nnd fee(s)cnn be brought to City Hatl,Room 205 or mailed to Inspection Scrvices,PO Box 1128,Oshkosh WI
54903-1128, Commencing work without permit(s)will result in fees being doub2ed or$100.00 plus the normal permit fee,which
ever is greater.
OR �
I�vou are a conlractor ak rtfci°attng�it the Permit Fe� Accoun( Syste�n and hava odequa�e tunde �y�ek here
if vou want �his nrocesssd throuP,�vour acc�nf I1
"'�'Advisory-�'or applicable projects,an Electrical Installation Verification(EI�form�signed by the Electiaical
Contractor or Homcowncr(for installations allowcd to bc performed by the homaowner)mnst be submittcd
with the permit application. Applicadons snbmitted withont an EIV when snch is reqnired,will not be
processcd for Permit Yssnance and will be retarned for completioa.
Job Address ��� �Ue�.aN'�N l�l�- VQIUB(Includingleborandrroterinls) (�70�'4 Date S'2��3
Owner Ma�K 4n1+�►� Contractor .D.�,c.ks PI�..,b�,��
�ingle Family ❑Duplex ❑Multt-Family ❑Rental QCommercial []Industrial
Number of Fixtures;
BathWb Sump Pump Plaster Sink Roof brain
Showu Snn.5ump/Pump Scullery Sink Sods Dtsp
vVhlripool Water Sotlener Service Sink �R'��
Lavat�y Stendpipe Rec Shamp SirJc Site Drdn
Toilet Ciaraae FD Surgeona S1nk W�py g�
Kit Sink Locel Wostc Skrifizcr Iw Chcst
D�P�� B�S� RPZ Velve Comm Ice Malcw
D'uhwashv Brenkcm Sink 6idet Int(3roa�e Tcap
Floo�Drain Classrm Sink Urinel �t��T�
Hose Bibb ��S�� 8cer Tep �y6 W�gy
Water Heeter _L F Prep Slnk Dipper Well p����
�Ure�Elect 0 PwrVnt Floor Sink Drink Fnfi Wtr Sewer M�
Ciothcs Wshr Hend Sink Wmh Fntn
Wtr Useaa Mtr
Lndry TroY Lab 5ink Catch Basin �F�
�� ,
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type , # Conn.Type
Sanitary Sewer � �
5torm Sewer
Water Servicc '
O6/09