HomeMy WebLinkAbout0158520-Plumbing (water heater) � CITY OF OSHKOSH No �5ss2o '
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2447 BLAKE CT Owner GARY G/SARAH J TROXELL Create Date 10/29/2013
Contractor D R GLAZE PLUMBING 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 Vaive 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory 0 San Sump/Pump 0 FINWst 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 MULTI-FAMILY/replace water heater �
of Work
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"ck#1239'` ;
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Size Material Type # Conn.Type
Sanitary Sewer ,
Storm Sewer
Water Service
Parcel Id#
0622050100
Valuation $800.00 Plan Approval _ $0.00 Permit Fees $30.00 ❑ Permit Voided'��
Issued By J��.. Date 10/29/2013
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 1865 JAMES RD OSHKOSH WI 54904 -6873 Telephone Number 920-589-4014
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 afOshko�h
� IrDgeciion Ser��ices Di��ion � �# ���� �
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Oshkostl4'�'I 54903-11�� ���1`t I�3
Phor�e_(9`�Cr}236-505� �`3L �����
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Plumbing Perm�tApplication
I herebti�a��ly for a penz�it ia c3o and�stall ttie faIla�•uzg phati�ing on tl�prenvses hereinafter describ�d,tY���-ark to rnnfarmto tl�
tt"i�cor�sin State Phn7i3in�Cade,a�tl�perforn�ice of«-hich all}�ar�ie�I�reia aQree tv and are bowxi l�y said s2atute�.
• �PP]icatmr�(s)and fee(s)canUe brou�Yrt to C�yHall Room?OS or mai]ed to Ir�pectian Ser�-�ce�,P�Bex l l?�,Oshkosli��'I
��94's-11'8. Coxrnr�r�cn�«•crrk t�-ithout penrri[(sj«-illresuk m fees heir�dout�kd ar�1t�t�.GO plw d�e nonr�l pzrinit�e.«-hicl�
eter is gt-eater. 5
OR
Ij�•nt�,are a col�tracto�c�t;.tic�a�i��ir��I�e Pernaar �ee .�ccoira�t Sz•stern as�c�' l�a;•e ade�tteate,,�`uz�d,s. claec�fz��_e
i�'i�ozr ~t•a��t_rlais pr•oeess�d rh3•ou h ��a�rr acc�un*[�
**Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed b�the Electrical
Contractar or Homeowner tfor installarions allawed to be performed by the hc�meowner)must be submitted
with the pernut apptication. Applica�ians submitted ivitha�t an EIV when such is required,will not be
pr�essed for Fernu#Issuance and will be returned far completion.
Job��ress �`IW7 Ai...�►�E COGRT `'alue(���a����,a�t��> ��� Date �o a I
Q��ner G�e t S.4sr..tH � L Gontractor �TZ C t�azF ��rs�
� []Single Fa�ih' []Duple� [ ti�Tulti-Famil�' �]Reutal []Cammereial ❑Industrial �
�
�umber ofFi�tures:
$adsil� Stun�Putnp FSastzr Sink Rti,ofDrai-a
Shc+r.-er S�Swrp Pca� Sculktt�Si31: _ Soda Dip
it'ktir3pcol Z["atzr Softex�r 5estirice�uudc Ca�e?t��
Lasator�- S�idpipe Rec ,"_„__ SBarnp Sir1: _,___,,,_, 5rte Draai
Toilet �ara�=rFD SureeorL Sa�k ��-aizs Stxa
It�Sir� LQCa1R'ast� Stzrilizer Ice Chest
Drgo_al $ar Sail: _ . RPZ�'ahe ComnI�z\laker
D�h�cashcr $rea�acn�a�1: Bidet int Cirzasz Frag ----
_._... �,IassrxnSia{t L'rinal __------ ExtGreaseIrap
Fb�Y Draaa. _._..�
Hote B$�E� Esarr;Snl: ___ $eer Tag -------- Eye�t'ash Sm '
t.`;ater Hearer � F Preg Siilc ----- Bipper��'ell ----- De�.tct l.eter _
�Gas Elect Ps,�ri`;st Fkror 5irt3t 33ra�kFnm Et'�Sett�er'1<I3
C1;thz>�t�shr _...._..__._.__ Hard Sinl: ��'ash Fntn �['a C`s��e 1iu
LndR�Tra�� Lat�Smk CatchBa�iri 1lrc Fi:h�es
Electric Contractor{for projects not req�riz-ing an E�'Form)
L�se 1�ature ofR�ork �c'Pc.4� �"'U /-�77Z
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