HomeMy WebLinkAbout0156893-Plumbing (water heater) � CITY OF OSHKOSH No 156893
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2659 W 9TH AVE Owner SUZANNE M BOERSCHINGER/MERLE E TELLt Create Date 07/25/2013
Contractor GARTMAN MECHANICAL SERVICES 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
Fioor 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 ,RES\Replace NG WH '
of Work i
Size Materiai Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1311970115
Valuation $750.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided'I
issued By �� Date 07/25/2013
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 PARK AVE 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. :
Jul, 25, 2013 11 : 23AM GMS INC No. 6380 P. 1
cty ofosr�osn
.�D -
Tnspection Se�vices Di�s�ion �
P 0 Box 1130 �
Oshkosh,WI 54903-1130
Phone:(920)236-5050
Fax�(920)236-SOSa � �\� H
w 7:+e wnrea
Plumbing Permit Application
1 hereby apply for a purnit lo do and install the folluwing plumbing on thc premises hereinafter describe�the work to conform to the
Wiseonsin Statc Plumbing Cod�,in the performancc of which all parties hereto a�ree to and are bound by said statutes-
• Application(s)and fee(s)can be brou�ht to City Hall,Room,205 or mailed to Inspeetion Services,p0 Box 1128,Oshkosh Wl
54903-1128. Commencing work without permit(s)will result in fees being doubted or 5100.00 pins t6e normal permit fee,which
ever is greater. .
OR
If vor� are a contractnrparticipating in the Permit Fee Accoun! Svs[em and have aileuuace l'unds check here
rf vnu wanr this »roce.s.sed thrq�h vour account ❑ ,
**Advisory-�'or applicable projects,an Electrical Installation VeriScation(EI�form, signed by the Elecbr,ica�
Con�actor or�omeowner(for installations allowed to be pe�or,med by the homeoaner)mnst be snbmitted
with the peimit application, Applications submitted without an EIV when sach is reqnn�+ed, will not be
pmeessed for Pe�it Yssnance and�be retarned for completion.� �y�
r/
Job Address ���/ ��� /T���UC(Including labar snd malcriel3) ���� av Date ��(` �
O ner � ��(� / ./ar—� Co�atxactox (S��S^ �r'-�.
Single Family ❑Daplex ❑Multi-ramily �Rental [�Commercial []Ynductrial T
Number of FYxtures:
Balhwb Sump Yitmp Yle�ster Sinlc Roof Drain
ShOwer S�n,SumpJp�p Scullery Sink Soda Disp
W6irlpool Walcr Sufteacr Service Sink (;offec Mkr
Lawdlory Slandpipd Rec Sh�np Sink Site Drain
Toilet Gar.�e 1�D S�geons S�nk � Waitrg 5tn
Kil Siok C,ocal Weste ' Sterilizcr Icc CFir�t
�iaposal Dw Siok RPZ Valvc Conun icc Maket
Dishwoa6er b��Sink Ciidet Int Grcaqc Trap
�luor Dr�ia ,___�__, Classrm Sink Urinsl Pxt G�ease Trap
Hose 8ibb r.xam Sink BccrTa� Fye Wash Sfn
�c Heater F Prep Sink Dipper Well Decluct Meler
0 El�sl Ywrunt Flaor Sink Drink Fnm Wtr Sewet Mir
Clothes Wshr Hsnd Sink Wa4h Fnt� WR Usage Mlt ,
��Y T�Y [.sD Sink Ca1ch Basin Misc Fixtures
�
Electric Contractor(for projects not requiring an EN Form)
Use/Nature of Work
' Size Macerial Type # Conn.Type
Sar�icary Sewer
Storm Sewer
Wate,r Service .
OG/09