HomeMy WebLinkAbout0158208-Plumbing (water heater) � CITY OF OSHKOSH No t5s2os
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1418 JEFFERSON ST Owner JEFFERY F LILL Create Date 10/11/2013
Contractor JOHN D RANSOM 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 FldWst 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 water heater
of Work
'debit Kitr&Pfeil acct**
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer .
Water Service
Parcel Id#
1505260000
Valuation $599.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided�
Issued By S�� Date 10l11/2013
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 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.
RI, OCT, 1l. 2013 10: 23 AM KITZ&PFEIL OSHKOSH FAX No, 920 236 3348 P. 001/001
Cify of�shk.osh '
Iaspaction Scrvic�s Divigioa ��
P 0 Box 1130
Oslil�sh,WI 54903-1130
phone:(920)236-5050 � ,�( �
Fax:(920)256-5084 . , � ��~�
. Oh Hb M+I.�TEB -
� Plumbing Perm'rt Application
I hercby apply fot a permit to do sud install the following plumbi.ng on the preruises heae:inafter.described,the work to conform to the
•'DVisconsin State Plumbing Code,in the perfornzance of which all pardes h�xeto agrce to and arc bound by said stattxtes.
• Applicatioa(s)and fee(s)can be brought to Ciry Hall,Room 205 or mailed to Inspeedon Services,PO Box 1128,Oshkor�h WI
' S�F903-1128. Comm�ein.g work'widaout pexmit(s)will xesult in£ees being doubled or$100.00 plus fhe normal pe�mit fec,vv3aich
evcr is greatez.
.OR .
If vou a-e o eontractor a tici attn. i the Perm t Fee Aecou'nt S stern and have ade uate urxds. check here
i vau w nt this rocessed throu h our accoun :
**Advisory-FoX applicable projects, an El.ectrical Installation'V'ezif.cation(E��orm, signed�by tbe Elec�ical
� Cotttxactor or Homeownec(for instaIlat�ions'a,iiowed to be pc�ormed by the homeowmcr)mnst be submitxed
with the permit a�plication. Applications submitted without an EIV v�hen such is regaired, will not be
� paocessed for Permit Tssuance and will be xet�a�rned for completion: �
� Job Address � e�SO Valae(���amg���a�g�
� Date �d� � �— ��
Owner ��� u l� . Contraetor ��h1n- G�.Y1 s��
�Sin.gle Faxnily []Duplex []Multi-Famil� (]xtental OCoYnmercial ❑In.dustzaal
11'inmber nf Fistures:
$athWb Disposal Drink Ftn Catch basin
'Whalpool Dishwesher Waic Sc 'Wash Fm
lavetoey S�mP Puur+P , I�`C�S� Unml
Toaet Ejector/Grind Exsm Siak Oar Drain
Ties.Sinl VJatcr Sofiner ScuycS'Sink . SOdB Disp
• Baz Sink ' �.ocal Wasoc . T�and Sinl ' Caffee Malcer ' '
wat�r EZeetu 'L Clothes W� •F Prep Siak Couun Ice Malcev
�' as�Elxt 0 pwr'Vnt Bidet Sav SmL � Sife Drain �
• Shower Bear Ts➢ Ynt C3ceasc 7rap Rmf Drem
• FlOOr Drnm � Ctasam SinL' Fxt Cnease TfaP � Standp 12ec .
E e'Wash Sm
��5'T�Y . Surgeons Sink . RT'.Z.Valve Y
Lab 6inY Brcal�Sink Shamp SmL' 'Wtr Sewer Mus
Plastec Si�1c Dip Well Plr/Wsc Sink Dedua[t��ecs
�� Hose$�bs� . . Wec Useve Mtts , .
Misc_ . . ' ' ,
Fixwres . .
Electrie Contractor (for pro�ects not reqtriri,�an an EI�'Form�) .
Use/Nature of Work_ Y��O�C-E. vJ G��^r' ►� - � .
5ize Material Type # . Conn:.T,ype � ' **�*�*�*�c*
� � � PL.EASE' TJSE 'PEiE
Sanitary Sewe�r KrT2�& PFET.L
StormSccver � � � , ' , ACGT. � �
� - � 'Thank You!
W ster Sesvice '
• � . NAN
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