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Home My WebLink About0104286 POSHKOSH ON THE WATER ,Job Address 2553 #B VILLAGE LN Contractor M P KELLY CITY OF OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD Owner JOHNPGERHOLD Category 411 - Residential-Water Heaters No 104286 Create Date 09/19/2003 Plan Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0 Whirlpool 0 Floor Drain 0 Water Soffner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0 Lavatory 0 Lndry Tray 0 LocalWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0 Toilet 0 Lndry Stndp 0 ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0 Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0 Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0 RPZValve 0 Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 0 Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0 Use/Nature CONDO/Replace electric water heater under warranty. *EIV form from TRuck Electric. of Work Size Material Type # Conn. Type Sanitary Sewer 0 0 0 0 0 Storm Sewer 0 0 0 0 0 Water Service 0 0 0 0 0 Valuation $283.00 Plan Approval $0.00 Permit Fees $20.00 ~J Permit Voided Issued By Date 09/19/2003 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 665 N MAIN ST OSHKOSH WI 54901 - 4431 Telephone Number 231-1750 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 Inspection Services Division POBox 1130 Oshkosh, WI 54903-1130 Phone: (920) 236-5050 Fax:(920) 236-5084 R I hereby apply fora pemt to do ~d install the follow,0g plmbmg on the ¢;~s~s ~r~;~ed, ~e work to co'om to ~e Wisconsin State Plumbing Code, in the perfomnce of which all pa~es hereto agree to ~d are bo~d 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 lf vou are a contractor participating in the Permit Fee Account System and have adequate funds, check here if you want this processed through ~2our account [~ Job Addressr-~O~'~ F~--~dP&~.~ value (inc,uding ,ahor ~.d m~tda,~l_~d:~<Dd'' O0 ~le Family ~Duplex DMulti-Family DRental Commercial Dlnaustrial Number of Fixtures: Bathtub Lodry Standp Dent. Oper. Shamp Sink Whirlpool Disposal Dip Well Flr/Wst Sink Lavatory Dishwasher Drink Fm Catch Basin Toilet Sump Pump Wait. St. Wash Fm Res. Sink Ejector/Grind Ice Chest Urinal Bar Sink Water Sofmcr Exam Sink Gar Drain Water Heater __~ Local Waste Sculry Sink Soda Disp r- Gas ~ect V~ pwrVnt Clothes Wshr Hand Sink Coffee Maker Shower Bidet .... F Prep Sink Ice Maker Floor Drain Beer Tap Serv Sink Site Drain Lndry Tray Classrm Sink lnt Grease Trap Roof Drain Lab Sink Surgeons Sink Ext Grease Trap Standp Rec Plaster Sink Bveakrm Sink Stcriliz~ ~ Electric Cont ractor/~(~¢~ ~/~~ O'R _ E~I~c Install~ition Verificatidn form attached (If Replacemen_t) 'Use/NatureofWor~~,~ ~¢~ .2~~ ~ e Material Type # Conn. Type Sanitary Sewer Storm Sewer Water Service 3/02 Office 920-236-5050 Electric Installation Verification (Elec'f'r~ca~ohntract or N ame),?h~ (Address) (City) (State) (Zip C_ode) have been contracted to perform electric installation work for ~r~//~.//~~62 , (Name of~y contac, ted th) at the following address: c~,~5"~-<..~ (~~w~r~/wi~llbe~pe~fo~ed)~X~) The nature of the work consists of: (Check One or Describe the Nature of Work) ~.~.Recomaectionl~ or new circuit for replacement Heating Plant and/or AJC Condenser. Reconnection or new circuit for replacement'Electric Water Heater. Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and lighting fixtures due to siding / soffit installation. Note: New Service Entrance Cables will require a separate permit. Reconnection or new circuit for other permanently wired appliances / fixtures. Other The value of this work is ~-9~'C~' cxD I hereby verify this work will be performed by an employee of this company and further verify the reconnection / installation will be done in compliance with manufacturer and Electric code requirements. ( Srignat~re ~f Company Officer) (Print ~hae of Officer) (Date)