HomeMy WebLinkAbout0156554-Plumbing (water heater) � CITY OF OSHKOSH No 156554
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1855 WHITE SWAN DR Owner RONALD UTERESA A LEWIS Create Date 07/05/2013
Contractor DRUCKS PLUMBING 8 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. 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
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\Install NG Water heater
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1523760000
Valuation 1,070.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I
Issued By Date 07/05/2013
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the Ciry of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perforrn 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 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 specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspectian is not performed within two business days from the time the project is ready.
-5-2013 11:51A FROM:DRUCKS PLUMBING C920)722-0651 T0:2365084 P.1
City of Oshkosh
Inspection Services Division �
P O Box l 130 �
Oshkosh,WI 54903-1130
Phona(920)23b-SOSO
Eax:(920)236-5084
ON THE WAT.
Plumbing Permit Application
I hcrcby apply for a permit to do and install thc following plumbing on tha premises hereinafter described,the work to conform to the
Wisconsin State Plumbing Code,in the performance of which all parties heroto 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 1 t28,Oshkosh WI
54903-1128. Commcncing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which
ever is greater.
OR
Jf',.yon are a contractor,pprttci2atinp rn tbe Pernrit Fee Acconrrt Svst�m and lrave ndenrrat�tunds cl�eck here :
�you want thrs nrocessed �hrourh yosr accn�inl n
**Advisory-For applicable projects, an Electrical Installadon Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)mnst be sabmitted
with the permit application. App�ications snbmitted without an EIV when snch is reqnired, will not be
processea for Permit Issnaace aad will be retarned for completion.
Job Address ��SS (�H�Ee S�� �' V1IUC(Includingluborandmaterials) �a7O � Date �'S"��
Owner ��..� Ltw ti S Contractor '�t`�S �/�S,r,�, :
(�Single Farnily ❑Duptex ❑Multi-Family ❑Rental ❑Commerclal Industrial
Number of Fixtures:
Bathtub Sump Pump Ploster Sink Roof D�ain
Shower Sen.Sump/Pump Scullery Sink Soda Disp
Whirlpool Waler SoRener Service Sink CotTee Mkr
Lavatory Srondpipe Rec Shomp Sink Site Drein
Toilcl Garagc FD Surgcons Sink Waitrs Sm
Kit Sink Local Waste Slailiur !ce Chest
Disposal Bur Sink RPZ Vnlve Comm Ice Muker
Dishwaahor Dreakrm Sink f3idet Int Grwse Tmp
Floor Drain Classrm Sink Urinul Ext arcase Trap
Hose Bibb Fxnm Sink Bar Tap Eye Wosh Stn :
Wnter Hea�er _j_ F Prcp Sin� Dipper Well Deduc�Meta
�iG�es i:Elxt�:PwrVnt Floor Sink Drink FMn Wtr Sewer Mtr
Clothav Wshr Hand Sink Wa.sh Fnm Wv Usago Mh
Lndry Trey Lab Sink Caich Basin Misc Fixtures
Electric Contractor(for projects not requ�ring an EIV Form)
Use/Nature of Work
Size Material Type # Conn.Type
Sanitsuy Sewar
Storm Sewer
Water Service
06/09