HomeMy WebLinkAbout0156662-Plumbing (water heater) � CITY OF OSHKOSH No 156662
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1275 MORGAN AVE Owner CHAD T GROBE/NADENE V GROTOPHORST Create Date 07/12/2013
Contractor RAUSCH 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 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/replace water heater
of Work
�ck#27754*'
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcei Id#
1217940000
Valuation $220.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided j
Issued By"�"VL� Date 07/12/2013
.,
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 1606 W HASKEL ST,STE A APPLETON WI 54914 -5032 Telephone Number 920-830-9222
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
City�f Oshkosh �
Ii�spection Services Division �
P O Bor l 130
Oshkosh, Wl 54903-1130
Phonc: (920)236-5050 OJHK0IH
f���: (920)23(-5084
Oh.l THE WATFR
Plumbing Permit Application
I hereby apply for a permit to do and install the follo�ving plumbing on the premises hereinafter described,the work to conform to the
Wisconsin State Plumbing Code, in tl�e perfor�nance of which all parties hereto agree to and are bound by said statutes.
• npplication(s)and fee(s)can Ue brought to City rtall,Room 205 or mailed to Inspection Services, PO Box I 128,Oshkosh WI
54903-1128. Commencing work without pennit(s)will result in fees being doubled or$I(����►�E+���Permit fee,which
ever is greater.
oR J�J1�d���
Z��3rl�,�ds cheek here
/j_.Z.ou are a coi�t�•actor varticipatirzQ in th;_Pern�it Fee Aeeoirnt Svsten: and ha
i�'Zou �na��t tliis processed tlzroz�Qh vour account n
DEPART�iEeT OF
** Advisory-For applicable projects, an Electrical Installation Verificatio }��2��the Electrical
������i'c�"sbi�•"st'o�a
Cos:wact�r or Homeozi ri�r(�'or instal�ations allowed to be performed by the homeowner)must�
e submitted
witlt the pennit application. Applications submitted without an EN when such is required, will not be
processed for Pernut Issuance and will be returned for completion.
,iob Address
� Q�'► �aIUC(Including labor and terials) �v �� Date �
(h�•ner _Contractor � ^-S C� �� '
[?�Single Family ❑Duplex ❑Multi-Family ❑Rental ❑Commercial ❑Industrial
Number of Fixtures:
Sum Pum Plaster Sink Roof Drain
Rathtub P P -
Shc��cer San.Sump/Putnp Scullery Sink �oda Disp
\Vhirlpoul Water Softener
Service Sink CoCCee Mkr �
I.a�aton Standpipe Rec Shamp Sink Site Urain
l oilet Garage FD _ Surgeons Sink Waitrs Stn
kii Sink Local Waste _ Sterilizer Ice Chest
[)i��posal Bar Sink
RPZ Valve Conun Ice Maker
I)ish�casher
Breaknn Sink Bidet ]nt Grease Trap
I�Ic��r I�rain
Classrm Sink Urinal t;xt Grease Trap
Exam Sink Beer Tap T:ve Wash Stn
{losc i3ibb -
, F Prep Sink Dipper Well t?educt Meter _._
Wa1er I leater ti`!tr Se�ver Mtr
�(�;as i�iilect 17 P���rVnt Floor Sink Drink Fntn
Clothes\Vshr Hand Sink Wash Fnm ti`/tr Usage Mtr _ �
[.ndrv l rav Lab Sink Catch Basin Misc Fixtures
I?lecti•ic Contractor (for projects not requiring an EIV Form)
llsc /Nature of Work 11�-�- Ct GL Gs����✓ //L� ��v � �� � v
pTl ---.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
06/09