HomeMy WebLinkAbout0156453-Plumbing (water heater) � CITY OF OSHKOSH No 156453
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1255 N WESTFIELD ST Owner KATHERINE A JACKSON Create Date O6/28/2013
Contractor GARTMAN MECHANICAL SERVICES 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
WhiMpool 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
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/installation of a water heater
of Work
i
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1611820000
Valuation $750.00 Plan Approvai $0_00 Permit Fees $30.00 ❑ Permit Voided I
Issued By St'3 - Date 06/28/2013
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 520 W SOUTH PARKAVE OSHKOSH WI 54902 -6470 Telephone Number 920-231-5530
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.
Jun. 28, 2013 11 : 05AM GMS INC No. 5962 P. 1
-�,nC�
Ciry of Oshkosh
Tnspection Serviccs Division �
P 0 Box 1130
Oshkosh,WI54903-It30 �
Phone:(920)236-5050
Fax:(920)236-5084 I�O �
aN THH w�T�a
Plumbing Permit Application
T hcrcby apply for a permit to do and install che following plumbiitg on lhe premises hereinaftcr dcscribed,the work to conform to thz
Wisconsin Siate Plumbing Code,in[he perEormance of which All parties here[o agree to and are bound by said statutes.
• Application(s)and fce(s)can be brought to City Hall,Room 205 or mailed to lnspcction Services,PO Box 1128,Oshkosh WI
54903-1128. Commcncing woek without permit(s)will result in fees being doublcd or$100.00 plus lhe normal pettnit fe�,which
ever is grea�cr.
OR
! nu ar a cuiitractor arti ' alin i�: the Per �'re Accnun S stem ond hav. de uaie �rn check here
i nu w n� this roce.rscd throar h orir accoun�
'�*Advisory-For app�cable projeets, a�Elec�cal Insta�alion Verifieadou(EIV)form, sigaed by the Electx�ieal
Conttactor or Homcowner(for installadons allowed to be performed by t�►e homeowner)must be snbmitted
with tlie peanit app�xcation. Applicapio�os sabmitted withoat an EN whe�such is required, wi11 not be
processed for Perntit�ssaance and wi1(be retarned for co�apletion.
Job Address �(,h:1� i1�uC(�nclvding labor en ms�cris ) �� Date : l I�
wner Contractor -
inglc Tamily Duplcx QMulti-Tamily �Rcntal
❑Commcrciat ❑Iadustrial
Number of Fixtures:
Bathlub Sump Yumn Plasler Sink Roof Dr.tin
Shower S�to.Stmip/Pump Stullery Sink Soda Dia�p
�v�P�� Wamr Saftcncr Serrice Sink Coffee Mkr
T.av�tory Standpipe Rx Sltamp Sink Sirc Drain
Toilat Gurage FD _,_ Sur6roone$ink Wail�Stn
Kil Sink Local Waatc Slerilizer Ice Ch�,st
Disposal Dur Sink RPZ Vnlve Co�tun Icc Meker
Dish�rasher Drwkrm Sink 6iddt In�Grease Tmp
Flour Drain Classrm Sink _ Uriaal
- Exl Grease7'rap
liusc k�ibb Cxam Sink Becr TnP F,ye Wash Sm
�• cr Heata I f�Prep Sink Dippcx Well Ueducl Mnter
Gus 0 Glcct LI PwrVnt f•loor Sink Driok l�nm Wlr Sewer Mtr
Clothes Wslv � �fund Sink Was6 fnm _.._ W�r Usage Mtr
Lndry'1'rey �S�� Catch k3asin Misc Pixturos `
Electric Contractor (for projects not requir�p,g an EN Form)
Use/Nature of Work
Size Material Type # Conn.Type
St�ciitsry Sewer
Storm Sewer
Water Service
06/09