HomeMy WebLinkAbout0156289-Plumbing (water heater) � CITY OF OSHKOSH No 156289
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 939 GROVE ST Owner BRUCE D SCHUTZENDORF Create Date O6/19/2013
Contractor D R GLAZE 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
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. 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 �SFR/replace water heater
of Work
"*ck#1224'**
Size Material Type # Conn.Type
Sanitary Sewer `
Storm Sewer
Water Service
Parcel Id#
1109760000
Valuation $825.00 Plan Approval _ $0.00 Permit Fees $30.00 ❑ Permit Voided�i
Issued By Date 06/19/2013
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 1865 JAMES RD OSHKOSH WI 54904 -6873 Telephone Number 920-589-4014
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type ot
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 Oshlcosh � �
(nspeclion SmicesDivision
P O Box 1130 � �
OshkosL,W[54903-1130 -
Phoae:(920)236-5050 �� �/�--�� �—/��--� .
Fac:(9Z0)236-5084 ��11L! .
ou rHF wnrFc
Plumbing Permit Application
I Lereby apply for a permit ro do and'mstall the followmg plumbing on the premises hereinafiez described,the work to mnform ro the �,
W iscwsm State Plumbing Code,in ihe perfmm�ce of wfiicL all pazties hereto agree to and me bound by said statutes.
• Applicatioo(s)mmd fee(s)c�be brought to Ciry Hell,Room 205 m mailed to Inspec[ion Services,PO Box 1128,Oshkosh W I �
54903-1128.Commencmg wodc withont permit(s)will resuh in fces bemg dovbled m S 100.00 ptus the nmmal pam it fee,which �
�VCf LS gTC81R. � .
oR � �# �z��
�•ou are a cont�actor�articinating in the Permif F¢e Accovnt Srstem and have adeauete funds check here .
iJ.you�canr this nrocessed th�ourh�•our account ❑ �
**Advisory-F�applicable projecls,an Electrical Iostallation Veri6cation(EiV)form,sigoed by the Electtical � ���
Coauador or Ha�eowcer(for iastaDatiaos allowed to be pecformed by the hameowna)must be submitted
wrth the peimit application. ApQtication4 submitUed without an EIV when such is cequited,will nat be �/�1.��(3
pracessed for Permit Issuan�e and will be retumed for campletioa 4 6 i
Job Address �9 C'��S"T Valae��do��me.s�> a�� Date �3
Oweer � �IIf,TZC-c�1�F Cootrador �_�V�Z� /�.l.1/'(LS/N�
�gle Family ❑Dapkz �Matti-FamilY QReatal ❑Commerclal �Indastrixl
Nrmber of Fatares:
Bahnb S�PPomp _ Ass�aSidc _____. RodD�ao .
Sbwa ___— Ss.SamP'�v —_— Saa�QYSdc ....._.__ SodaDisp �
FLiApod waa sd�ena Swice siok _ CaH«.Wx ---�
Lavray Srdpipe R« _ S6mp Sot _ Site Aia �
Tale ___.__ GaageFD Surge�sSok ..._.._.. Wi1n5b ...___ �i
Kit Selc Lod Wa� �__�_ Sealiia __— ke Che4 ___
Di�posd .._.._ HrSivk _.____. RPZVah�e ...._.._. CammlceWk« �.
Dishwuhc Brc�m Smk Bide In[Geae inp _ .
F7oarAran _.....� GasQmSiok l:.md EuGreasrirap
HoseB'66 Ei�Sink .. _.. BecTy _..._ EyeR'avh5m _
R'rc Heacr I F Prep Siek _ D�PPa�Vdl Dehia Meta ,
�C Elect AnVat Elaat Siok __ Driek Fam _._ _ Wt SewQ Mlr _____ � .r!'�e^ .
- �' _ �_ ���ED
n�bnW� _._. HsdSiek R'a�Fam R'trlisageNtr .
Lndy Twy Cb Smk Ca 1 Bs:o �fisc Futu�es �..
.fi
_ _ -- f
Electric Contrador(for projects not reqairmg an EIV Form) �v\� 1 g 2��3
Use/Nature ot Work �C� q��(j�
Size Maerial Type k Conn.Type s}r..}'.�.t�'��;\T�:.���y()F
sanimrysewer CO�'';.����;;T�'V:?S'?F:I_OP1IE:VT
s��s�
�1VSPE�T}v:v�ik�'ICES DiVIS1Q�Y
Warer Srnice �
06/09