HomeMy WebLinkAbout0157487-Plumbing (water heater) � CITY OF OSHKOSH No 157487
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 215 WAUG00 AVE Owner WINNEBAGO COUNTY Create Date 08/30/2013
Contractor WINNEBAGO COUNTY Category 446-Commercial-Water Heaters Plan
Inspector Jon Mueller
Bathtub 0 Clothes Wshr 0 Classrtn 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
Whirlpooi 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. 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 COMM/ replace water heater —
of Work
"ck#81464501"
1
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0200250000
Valuation $650.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided'i
issued By ' Date 08/30/2013
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 w' in an easement,the City strongly urges the permit applicant to contact the
easement holder s d se re necessary approvals before starting such activity.
Signature Date ,g������
AgenUOwner
Address 6 CTY RD Y OSHKOSH WI 54901 -9775 Telephone Number 232-1962
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 /� g`y���(��
Inspection Services Division � ��
P O Box 1130 � �p �
Oshkosh,WI 54903-1130 36 `
Phone:(920)236-5050 g6�a� � 0 HKO H
Fa�c:(920)236-5084 ��
ON THE Wr1TER
Plumbing Permit Application
I hereby apply for a permit to do and install the following 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 greater.
OR
I�vou are a contractor participatinQ in the Permit Fee Account Svstem and have adeguate funds, check here
if vou want this processed through vour account n
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical
Contractor or Homeowner(for installations allowed to be performed by the homeowner)mnst be sabmitted
with the pernut application. Applications sabmitted withont an EIV when snch is reqnired, will not be
processed for Permit Issnance and will be retarned for completion.
.,[ C (''�\�
Job Address�I� OQ �. VaIUe(Including laborand materials) ✓�vC� l.l Date 3b ZO
Owner W1(1 O Contractor �.;,.e��n ��,urry �c=� c�—��c:.'�c�'RtGIR�I'
❑Single Family Duplex ulti-Family ❑Rental �Commercial ❑Industrial
Number of Fixtures:
Bathtub Sump Pump Plaster Sink Roof Drain
Shower San.Sump/Pump Scullery Sink Soda Disp
Whidpool Water Softener Service Sink Coffee Mkr
Lavatory Standpipe Rec Shamp Sink Site Drain
Toilet Garage FD Surgeons Sink Waitrs Stn
Kit Sink Local Waste Sterilizer Ice Chest
Disposal Bar Sink RPZ Valve Comm Ice Maker
Dishwasher Breakrm Sink Bidet Int Grease Ttap
Floor Drain Classrm Sink Urinal Ext Grease Trap
Hose Bibb Exam Sink Beer Tap Eye Wash Stn
Water Hea er � F Prep Sink Dipper Well Deduct Meter
Gas�Elect__PwrVnt Floor Sink Drink Fnfi Wtr Sewer Mtr
Clothes Wshr Hand Sink Wash Fnm Wtr Usage Mtr
Lndry Tray Lab Sink Catch Basin Misc Fixtures
Electric Contractor(for projects not requiring an EIV Form)
Use/Nature of Work �G('(,s�,� ��b ,� � �a 11�' � Z� G,l,q�f�- �F
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer :
Water Service
06/09