HomeMy WebLinkAbout0155754-Plumbing (water heater) � CITY OF OSHKOSH No 155754
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1771 BERNHEIM ST Owner FRANCISCO J/SUSAN M ZORNOSA Create Date 05/22/2013
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 FldWst Sink 0 Bidet 0 Site Drain 0 Misc. p
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 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
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#1887
— -----_ -- --
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1332160000
Valuation $850. 0 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I
Issued By ��_ / I 1(/v Date 05/22/2013
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 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.
�CEIVED
c�ty of ost�oSn �
Inspection Services Division M�Y � � ���3 �
P O Box 1130
Oshkosh,��I 54903-1130 '
Phone: (920)236-�050 �Ep�RT;►fE1T OF Of HKO1H
Fa�: (920)?36-�Ob4 I SPEC'T p\ScKE C 4ODnIS,Q'V
ON THc VJATER
Plumbing Permit Application
I hereb��appl}r for a pernut to do and install the following plumbing on the premises hereinafter described,the work to conform t�.tY,e :
Wisconsin State Plumbing Code, in the performance of��hich all parties hereto agree to and are bound by said statutes.
• Application(s)and iee(s) can be brou�ht to City Hall,Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s)will result in fees being rloubled or�100.00 plus the
normal permit fee, which ever is greater.
OR
If �ou are a contracror �arricinating irz the Por»iit Fee Account Svstem. and have ede�uato funds check her��
if rou want this nrocessed throu�h vour account ❑
1'"��1 C � ���(.�' � Date S-/`l- a o l3
Job Address ! l 1 � e�h�(J�(�.Ti `�a�UC (Inciuding labor and materials)
c �v�`� �G(.hS b r—
O�•ner �Ya ns i s c� Z D�'no�i�. Contractor ,
[�Sin;le Family ❑Dupl�x ❑Multi-Famiiy ❑Rental ❑Commercial ❑Industrial
NuFnber of Fixt�res: �
Bzth*.uo Lnd;y Standp Dent.Oper. Shamp Sink ___._
R%hiripooi D;spnsal Dip Well F]r,�Wst Sink
Lavato�� Dishwasher Drink Fm Catch Basin ____
Wait.St. Wash Fm ___
7o�]e; Sump Pump —
Res.Sink Ejector/Gnnd Ice Chest Urinal ___.
Bar Sink �ater Sofiner Exam Sink Gar Drain
Vdate-Heater � Locai Waste Sculry Sink Soda Disp __._. _
�ias�Eiect��PwrVn: Clothes Wshr Hand Sink Coffee Maker ___..
Shower __ Bidet F Prep Sink ____ Ice Maker __.
Fioor Drain Beer Tap Serv Sink Site Drain , '
Lndn Tray C1ass*.m Sink Int Grease Trap Roof Drain _ __
I.ao Sink Surgeons Sink Ext Crrease Trap Standp Rec ___.
Plasier Sink Brealcrm�ink :
Stenl�zer
Electric Contractor OR ❑Electric Installation Verification form attached
{If Replacement)
L;se / Nature of VE'ori� 'r���aC-t'- CAS W� �r ���p'r ---
�� Size Material T�pe =� Conn.T_ype �
Sanitary Sewer �
I
,
� Storm Sewer
� ��'ater Service i
3 I c',