HomeMy WebLinkAbout0104121-Plumbing (water heater)OSHKOSH
ON THE WATER
,Job Address 1260 N WESTFIELD ST
Contractor M P KELLY
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner ELIZ B DAVIS CHILDRENS HOME
Category 441 - Industrial-Water Heaters
No 104121
Create Date 09/11/2003
Plan
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 0 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 Lndry Stndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0 RPZValve 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature COMM/Replace gas water heater.
of Work
Size Material Type # Conn. Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Valuation $2,498.00 Plan Approval $0.00 Permit Fees $20.00 ~ Permit Voided
Issued By
Date
09/11/2003
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 665 N MAIN ST OSHKOSH WI 54901 - 4431 Telephone Number
231-1750
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 O Box 1130
Oshkosh, WI 54903-I 130
Phone: {920) 236-5050
Fax: (920) 236-5084
Q/t-KO/H
I hereby apply for a permit to do and install the followipg 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 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is ~eater.
OR
If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
if you want this processed through your account
Job Address ~, ~/0/~ ]/~'ff~t~Value 0nc'uding'aborandn~teaa'sL~94-.~/' 0d Da,e~
Owner ~~ ~.:~~r~cto r
~Single Family ~Duplex ~Mulh-Famlly ~Rental ~ommerclal ~Industrial
Number of Fixtures: ] - ' . -,
Bathtub ,: .... .;,.;/~ ~d{~ Stafidp Dent. Oper. ........... Sha~ Sink
Whirlpool Disposal Dip Well Ylr/Wst Sink
Lavatory Dishwasher Drink Fm Catch Basin
Toilet Sun~ Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Sot~ner Exam Sink Gar Drain
W~eater ~ Local Waste Sculry Sink Soda Disp
D Elect ~ PwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower Bidet ..... F Prep Sink ----. lee Maker
Floor Drain Beer Tap Sew Sink Site Drsin
Lndry Tray Classrrn Sink lnt Grease Trap Root'Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Pinstet Sink Break~m Sink
Sterilizer
Electric ContraCtor ~ I--]Electric Installation Veriflcati6n form attached
~ (If Replacement)
'Use / Nature ~f Wosk~/~-~.~4~ ~
Sffe Material Type # Coma. Type
Sanitary Sewer
Storm Sewer ; ' '
I Water Service
3/02