HomeMy WebLinkAbout0158612-Plumbing (water heater) �
� CITY OF OSHKOSH `
� No 158612
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1349 LIBERTY ST Owner MARY C HIELSBERG Create Date 11/05/2013
Contractor MERTEN PLUMBING&HEATING INC Category 410-Residential-Interior 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. p
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. p Fixtures
Kit Sink 0 Standp Rec 0 Lab Sink 0 Beer Tap 0 Ice Chest p
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 Drein 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/Replacing water heater
of Work
i*Paid with check
�—
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1206220000
Valuation $795.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided;
Issued By Date 11/05/2013
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
Agent/Owner
Address 1087 COZY LN OSHKOSH WI 54901 - 1404 Telephone Number 231-6795
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 specifed 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.
C'rty off�OSh �
lt�spection Setviccs Division
P O Box 1130 �
Oshkosh,WI 54903-i t30
Phone:(92f1)23�5050
Fax:{920)236-5084
ON THE WATER
�1,11�3iAt� �f t�11# ��1CA�#t)1�
I�Y sPPaY fcx a p�it in do md;nstau the fouov►ring pl�mbing on me pcemisea hereinaftcr a�ibea,the vworkk to conform to che
Wisconsin State 1'lumbing Code,in the performance of which all parties hereto agme to and are bound by said statutes.
� Applicati�n(s)sad fce(s)can be brought to City Hall,Room 20S or mailed to Inspearon Servic�,PO Bwi l 128,Oshlcoet�WI
54903-1128. Commencing work without permit(s)witl resuit in fces being doubled or 5100.00 plus the normal permit fce,which
eva is greatcr.
OR
I!vou are a contractor particigati� in the Pereiit Fee Acco�nt Svste�u and have ade4�ate funds. check here
�vou want this processed ihrough vour accourrt n
**Advisorp-For spplicabk projeds,an Electrical Insmll�tio�Verificatiia�(FIV)fn�m,si�ued bY the E>ec�rical
Con�act�or or Hom,eo�raer(fa�r�ions aHowd to�e pedo�me�by the homeown�a)m�st be s�b�mitbed
with the pamit applicatiton. Applicatio�s sa�ed witbont an EIV whea s�ch is reqaued,w�l not be
pmcessed far Pem�it isstana ana w�be nt�mei t�nr coaaipletion.
dob Address Valae��a���a�s� .� Date b
Owner Contractor '
�gle Fam7y Dapkz OMniti-Fam�y ORe�ta� OCo�m ' 1
Number of F'iztares:
BathWb Sump Pump Plasta Sidc Roof Disia
Shower San.Sump/Pump Scullay Sink Sods I�Sp
Wttirlpool Water Softeou Service Sink Coffx Mla
Lavatory Standpipe Rec Sham�Siidc SitcD�ain
Toilet Garage FD Surgeau Sidc Wa�s Sm
�c;t s� �w� sc�►� �cnac
nlsposal Bar sink ttPZ valve comm tce t�taka
p���� Brw�m Smk Bidet lnt Qreax T�
Floor Ihain Classrm Sink Urinal Ext Grease Trap
Hose Bibb � £�m Srot Bar Tap L�e Wat6 Sm
W�F� F Prop Sidc Dipper Well Doducc Mdc
,�L('ms 0 Eloct�PwrVM Floor Sidc Dridc Fnm Wtr Sewec Mtr
C���W� Haod Sidc Wash Fom Wtr Usage Mtr
�Y TBY Lab Sinl� Catch Basin Misc Fucw�es
Electric Contrxctor(for projects not r+equiring�n EIV Form)
Use/Natnre of i�Vork
Size Mataia( Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
06/09