HomeMy WebLinkAbout0158668-Plumbing (water heater) �
� CITY OF OSHKOSH No 158668 �
_
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON TNE WATER
Job Address 609 N LARK ST Owner JAMES A/MARY K DELIKAT Create Date 11/07/2013
Contractor D.R.HANSEN PLBG. 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 Flr/Wst 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 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 Drain 0 Bar Sink 0 Serv Sink 0 Wash Ftn 0 Ext Grease Trap 0
: Hose Bibb 0 Breakrtn Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 1
Use/Nature SFR/replace water heater - -
of Work
'*debit acct**
�
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1604190000
Valuation $760.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided�
Issued By �JVVV Date 11/07/2013
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 55 KNAPP ST OSHKOSH WI 54902 -3448 Telephone Number 233-1595
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 o�Oshkosh
Inspection Serviice,�Divisinn �
POBoxlI3U �
osn�ogn,WI 549U3-i�30
Phone:(920)236-5050
Fax:(920)236-5084 KO H
ON TME U/A7;k :
Plumbing Permit �ppl�cafiion
a hereby apply for a pecmit to do and install the follawing plumbing on tha premises hereinaftcr dcseribed,the work to conform to the
Wisconsin State Plumbing Code,in the performance of which all parties hereto agrcc to and are bound by said s�atutcs.
• ApplicArion(c)and fee(s)can bc brou�t ta City Hall,Room 205 or mailed to Tnspection Scrviccs,PO Box 1128,Oshkash Wl
54�03-I 128. Commencing work without permit(s)will result in fees being doubted or�100.00 plus Che normal permit fee,which
cvcr is gr�atcr.
OR
/f vou are a con��c�or narlicinaling '�,l_h� 1'erinit Fee �lccount �L+,;�,em and have adeQaa1e1u1t,ds„�,�heck hare
�Q,�,�pent tl�i.� nrocasse_d.ti�CQ�fh voa�r accnYn!__n
**Advisory-Fox applicable�rojccts, an Electrr�ica�Titstallatian veriS�cation(F.��form,signed by the�lecerical
Contractor or Honneownc�r(ffar iastellations allowed eo bc performed b�►d��honaeownar)mnst be sabnnitted
with the permit app�ica�ion. A�licat3ons sabna�tted wi.ti�out an IIV whaa sacb�is rc�nixed,�v�l dot be
�nrocc,sccd�or P�uit�ssaattce�nd w�l be retuax�ed�'rnt complction. � •
,Tob Address � � C. VaIUe(Inelnd'mg labcrc end matcrials) � � • C� Date �� � �
�' ' U ' r �.
Uwncr 1M CO�t�actpr . 1� C
❑Singlc FAAnily �]Dnplex ❑Mul�k'amily �Rcntal r]Commcrcisl �I strial
Number o�'Fixtures: �
Bathtub Sump Pump Plastcr Sirilt RoofUrein
Shower 5an.Sump/Pump Scullery S�nk Soda Diap
Whirlpoel Wstcr S�ftcncr ,,,� �ervice Sink CnEi'a Mkr
l.mntory Slandpipe Ra Shomp Sink Sitc Dr,�in
Tnilcl GpreRa FD 9urqeom Sink Wnius$m
Kit Slnk �oCal Waetc 3uxilizc �ca Cheat
- Disposc� Bar Sink RPZ vnlve Comm!cc Makrr
��� Drcakrm Sink Aida !nc Gren.n.�c'Rap
FI��Drain Cl�ssrm Sink Urit�l Exl GI2�lce Trnp
H4ao Bibb �,x'U^�irtk BcerTap Eye W:nh Sm
Wn�r Hcetcr „�,,,^ F Prcp Sink Dipper Woll Dcduct Mcta
IN Gas U Elxt tl 1'�vrVnt Floor Sink brink Fntn Wtr Scwer M!r
Clothos Wsfir Hand Sink ' . Wanh Enai •. Wv[Iaagc Mtr
L�dry Trny l.nb Sink Cnteb Fsa.Rin . Mise Fi:nur�n
Elcctric Contractor(��r projccts not requiri��an E�'V Form)
Use/Nature of Wor�C
Si�,e Material '�pe #_ _ Conn.Type =
Sanitary Scwcr
Storm Sewer
Watcr Scrvice
06/09