HomeMy WebLinkAbout0158490-Plumbing (water heater) � CITY OF OSHKOSH No �5saso
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1407 WISCONSIN ST Owner JOHN R HASKAMP Create Date 10/28/2013
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
Whirlpooi 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
Disposai 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 water heater
of Work
*debit Kitr&Pfeil acct"'
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
� 1210130000
Valuation $449.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided�
Issued By ��/1� Date 10/28/2013
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.
ON, OCT, 28, 2013 11 : 27 AM KITZ&PFEIL OSHKOSH FAX No. 920 236 3348 P. 001/001
City of Osbkosh �
Inspcction Services Division . �
P O Box 1130 •�
4shknsh,WI 5�903-1130 •
P�onc:(920)236-SO50 � . •� .
Fayc:(920)236-5084 � - _
. ON a iNATER .
Plumbing Permif Application � :
I heroby apply for a pezmit to do at�d install thc followiag plumbing on the prcmises harcivafter.descn'bcd,tht work to confornz to the
'�V'isconsin State Plumbing Codc,in the pexforniancc of which all parties heresto agree to and are bound by said etaurtes. :
� Application(s)and fae(s)can be brough#to City I3a11,Room 205 or mailed to T.aspcction Scrvices,PO Box 1126,Oshkosh WX,
' $4903-1128, Commcnciag work wi[bou#pennit(s)vrill result in fxs beiug double�or$100.00 plus thc nor�e.l pcimit f.ee,which
sver is p,reater._
OR . •
1 vou are a contractor arti.ci atin in the Pe mit Fee rlcnouzzt ,5 siem an have ade uate unds. check here
f �ou want this rocessed throu our acco . t �
**Advisorp-�'oz applicable pxojects, an E�ectrical Iustallati.on Verifics,�ion(EI�foan, sign�ed by the Eleccrical .
Contr'actor or HomeoRner(for installati.ons�allowed to be pezformed b�the homeown.cr)mnst be submitted
with the pe�iC applica,tion. Applications sabmitted�c�ith�nt an EY'tr when.such as required, will nox be
' pzocessed for Perm:it Issuanc�a�d vaill be retux�ucd for completi.on, •
�
� J'ob Address � �b� U�1►S o ns� n �slue(Inctu��ebor aod mBc�als) Date l � " Z �' �/ �
Ovrner �GCk � a s ka�'�^� . Contractor ���� �S�!�'` .
�Si.ngle Ramilp [,Dupler QMulti-Family �ktental []Co�mercial ❑xndu,striaL
Numbex.of Figtures: �
BefLaib � Ai�Po� Arinlc Fm Cawh Basia
Whjrl,ppol DishWSSher Wair SG wesL F�t
Iavatory' Stunp P�p Tce Cbast ' C7rinal
Totiec Ejx.tar/Gdnd �xam Sink C�ar D:am
Res Sink F+aux Soimer Sculzy Siak . Soda DiSp
� Be=Sink Loca]DVeste I3snd SinL' ' CoEYcc Maker . '
Waza Hmter Y� Cioihcs welu •P l�ey S�nl: Comm Ice M�cuu
�Oas 0 Elxt 0 Povr'Vnt �ideE Serv Smlt Site Dram '
• Showar � BeerTap 'ln�dreaseTxap Rooflkaie
Floor Draia � Classrm Sink Ext Cmnse Ttap �'dP� -
�y T�Y . S�geohs Sink . RpZ,Valve �ye W'ash Sm
Lab Sinlc Brealam Sink Shamp Smk VJa Sewer Mcs
plesYer Sink bip'Well Flr/a3st Siak � Acducc Me[e�'s
�� �nse B�bs� . Wtr Usage Mtrs .
2vlisc. ' • . .
Fiznaze ' .
Electxic Contractor (for projects not requiring an ET'�r Form) . �
Use/Nat�re of Work 1—� c�C�° vJ �r h �`�
Size Matecial Typc #i . Conu:..Type • � *��k**,��r**�:
Sani Sevc�esr PLEASE USE '1'fiE
. �'. . . , KITZ,& PFE7Z
StormScwar � • . ' . . ACG7'. �
. . . 'Thank You!
VJatcs�ercrice � �
. � • NAN
. ��'�f�9a o� o� :