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� CITY OF OSHKOSH No 157647 �
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OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD V O I D
ON THE WATER :
Job Address 1217 OSHKOSH AVE Owner WILLIAM/LORI JAGE Create Date 09/11/2013
Contractor O'NEILL ENTERPRISES 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. 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 FR\replace WH
of Work '
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Size Material Type # Conn.Type '
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1608430000
Valuation $700.00 Plan Approval $0.00 Permit Fees $30.00 ❑✓ Permit Voided I WRONG CONTR
Issued By Date 09/11/2013
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 522 W 6TH AVE OSHKOSH WI 54902 -5916 Telephone Number 920-230-2007
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.
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/�"# CITY OF OSHKOSH No 157647
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1217 OSHKOSH AVE Owner WILLIAM/LORI JAGE Create Date 09/11/2013
Contractor O'NEILL ENTERPRISES 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. 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 WH
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1608430000
Valuation 700.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I
Issued By } Date 09/11/2013
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 522 W 6TH AVE OSHKOSH WI 54902 -5916 Telephone Number 920-230-2007
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.
PLUMBING PERMIT APPLICATION Page 1 of 2
Krause, Adam
From: PLUMBING PERMIT APPLICATION [Permit_App_Plumbing@ci.oshkosh.wi.us]
. Sent: Wednesday, September 11, 2013 6:21 AM
To: Inspections, Inspections
Subject: PLUMBING Permit Application
PLUMBING PERMIT APPLICATION
Date:9/11/2013 6:20:46 AM
Permit Fee Account yES
System:
Job Address: 1217 Oshkosh Ave
Owner:
Contractor: J.Rasmussen Plg Inc
Use Category: Single Family
FIXTURES
Bathtub: Sump Pump: Plaster Roof
Sink: Drain:
Shower: San. Scullery Soda
Sump/Pump: Sink: Disp:
Whirlpool: �'�'ater Service Coffee
Softener: Sink: M�-;
Lavatory: Standpipe Shamp Site
Rec: Sink: Drain:
Toilet: Garage FD: Surgeons Waitrs
Sink: Stn:
Kit Sink: Local Waste: Sterilizer: Ice
Chest:
Comm
Disposal: Bar Sink: �Z Ice
Valve:
Maker:
Breakrm Int
Dishwasher: Sink: Bidet: Grease
Trap:
Floor Classrm Ext
Drain: Sink: Urinal: Grease
Trap:
Beer Eye
Hose Bibb: Exam Sink: Wash
Tap: Stn:
9/11/2013
PLUMBING PERMIT APPLICATION Page 2 of 2
Water 1 F Prep Sink: Dipper Deduct
Heater: Well: Meter:
Drink wtr
Gas Floor Sink: Fntn: Sewer
Mtr:
Clothes Wash Wtr
Wshr: Hand Sink: Fntn: Usage
Mtr:
Lndry Lab Sink: Catch Misc
Tray: Basin: Fixtures:
*USE/NATURE OF WORK replace water heater
*VALUE 700 '
ELECTRIC CONTRACTOR
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
9/11%2013