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Home My WebLink About0157898-Plumbing (water heater - Apt #B) � CITY OF OSHKOSH No 157898 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 635 STARBOARD CT WEST Owner BLACK WOLF INVESTMENTS LLC Create Date 09/24/2013 Contractor JOHN D RANSOM Category 446-Commercial-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 FIrIWst 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 4�-UNIT(APT B)/REPLACE ELECTRIC WATER HEATER, ELECTRICIAN IS SECKAR ELECTRIC '*check#1974 of Work ' �------ -- Size Material Type # Conn.Type Sanitary Sewer Storm Sewer Water Service Parcel Id# 1524901100 Valuation $375.00 Plan Approval $0.00 Permit Fees __ $30.00 ❑ Permit Voide� Issued By('�� Date 09/24/2013 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 W5056 PARADISE LN FOND DU LAC WI 54935 -9662 Telephone Number 920-922-1987 To schedule inspections please call fhe 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. RECEIV ED City of Oshkosh � Inspection Services Division . SEP 2 3 ZO�3 � P O Box 1130 Osnl:osh,�'I 54903-1130 Phone:(920)236-50�0 �eN.aKT��e�T��' ��uV��(� Fax:(920)236-5084 C011�IU�IT\'VE�ELtN'�►EVT 1 1� r � IVSPE('TI(1�SEk�'ICE�DI\'ISIO.�' o�:�H= v✓r+t�rs Plumbing Permit Application I hereby apply for a permit to do and install the following plumbing on the premises hereinafter deseribed,the work to conform to the Wisconsin State Piumbing Code,in the performance of which all parties hereto agree to and are bound by said statutes. • Applicarion(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI 54903-i 128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal pernut fee,which ever is greater. OR I vou are a contiacto� participatin� in the Permit Fee Accou�7t S>>stem and have adeauate funds. checl: he��e rJvou war�t this processed throu�h your account ❑ **Advisory-For applicable projects, an Electrical Installation Verification(El��form, signed b}•the Electrical Contractor or Homeowner(for installations allowed to be performed b3•the homeowner)must be submitted with the permit application. Applications snbmitted without an EIV when such is required, will not be processed for Permit Lssuance and will be returned for completion. �P�SL S"�Ci✓�I v r� C� ( � ✓� �S� Date �J� ��` � Job Address u � � alue Includino labor and marerials) Ov��ner t5 a -�r S n -P P S Contractor ��`^��`� �� ❑Single Fa �� ❑Duplex �Vlulti-Famil�� ❑Rental ❑Commercial DIndustrial ?1Tumber of Fi�tures: Bafnrub Disposal Drinl:Fm Catc�Basin VJhirlpool Disha�asner Wait.5t R'ash Fm L,avatory S�P p�P Ice Chest lirinal Toilet Ejector/Grind Exam Sink Gaz D:ain . Res.Sink Water Sofiner Sculry Sink Sodz Disp Bar Sink Local W aste Hand Sink Cofiee Maker Water Heater � Clothes W sh: F Prep Sink Comm.Ice Maker ❑Gasl'�:Elect C Pa�Vnt gidet Serv Sinl: Site Ihain Shower Beer Tap Int Grease Trap Roof Drain Fioo:Drain Classrm Sink Ext Grease Trap Standp Rec Lndrv Tray S�g��S� RP.Z.Valve Eye Wash Sm iab Sink Bre�5� Sbamp 5inb VJU Sewer Mtrs Plaste:Sink Dip Well Fir/Wst 5in}; Deduct Meters Sterilizer Hose Bibs Wtr tisage D�ius �s�. �P� Fixtures � Electric Contractor (for projects not requiring an EIV Form) Y'Cn�� e O 1�' `�J-�Gk�r tise/Nature of Work Y� ��c . vJ c.��f hPc�C�� - v Size Material T}pe � Conn.Type **�*****�* �� Sanitary Sewer Storm Sewer "'�""� V��ater Senrice �� C7 07 V