HomeMy WebLinkAbout0158725-Plumbing (water heater) /�"� CITY OF OSHKOSH No 158725
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 132 W 9TH AVE Owner WILLIAM J/DONNA HAYES SR Create Date 11/11/2013
Contractor WATTERS 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 Valve 0 Coffee Maker 0 Wt�Usage Mtrs 0
Lavatory _ 0 San Sump/Pump 0 Fir/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 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 �FR/REPLACE POWER VENT WATER HEATER,EIV SIGNED BY BELL ELECTRIC "debit acct
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0301110000
Valuation $1,500.00 Plan Approval _ $0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By �-�-I-Ll� _ _-- — - Date 11/11/2013
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 PO BOX 118 _ MENASHA WI 54952 -0118 Telephone Number 920-733-8125
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 pertormed within two business days from the time the project is ready.
11/OS/2013 FRI 10: 57 FAX 920 733 2713 watters Plumbing �001/002
City of Oshkosh
Inspection Services Division � `
P O Box 1130 �
Oshkosh,WI 5�4903-1 l30 �'^/ ��
Phone:(920)236-5050 J 2 "�
Fax:(920)236-5084 �l� HK H
� ON THE WATER �
. Plumbing Permit Applica�ion
I hereby apply for a pernut to do and install the following plumbing on the premises hereinafter described,the work to conform to the
Wisconsin State Plumbing Code,in the performan�e of which all parties hereto 3gree to and are bound by said statutes.
• Applicatiun(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI
54903-1 1 28. Commencing work without permit(s)will resuit in fees being doubled or$100.00 plus the normal pezmit fee,which
ever is greater. �
OR
1 vou are a conrraclor artici atin in t.he Permit e Account S stem and have ade uate unds check her¢
i ou tivant this rncessed throu h our account.
**Advisory-For applicable pzojects, an Electrical Instai.lation VeriScati�on(EI�form, signed by the Electri�al
Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted
with the permit application. Applications submitted without an EN when such is required, will not be
processed for Pexmit Issuance and wi11 be return d for compledon.
� Q as�• /-- � — �( / �
Job Address I� Q` � "/ ���i� Va(Ue(Including labor and materials)�L � Date /l'U rU
Owner `,������k'Y" Contractor C�if'/�S �1 V INl�f 1��'i _
�ing(e Family Duplea �Multi-Family ❑Rental ❑Commercial ❑I dustrial
t�lumbe��of Fixtures:
BaUitub Sump Pump Plaster Sink
Roof Drain
Shower San.Sump/Pump Seullery Sink Soda Diap
Whirlpool Water Softener Scrvice Sink Coffee Mkr
I.avatory Stnndpipe Rec Shamp Sink Site Drain
Toilet __ Gang¢FD Surgeons Sink Waitrs Shi
Kit Sink Local Wasle Sterilizer Ice Ch�.wt
Dispos�] Bur 5ink __ RP"L Valve Comm Iee I�tuker
DishwaRher Breetam Sini: $idet Int Grease Trap
Flaor Drain Claesitn Sink Urinal Ext Cneuse Trap ^
Fioae Sibb / Exam Siak BeerTap Fye Wasl�Stn
WaterHeatcr , �►/ FPrepSink DipperWdl DeductMcicr
U Gas U Elect����nc Floot Sink
Drink Fntn WG•Sewer Mtr
Clothea Wshr Hand Sinl: Wash Fntn V✓tr Usage Mtr
Lndry Tray Lab Sink Catclt Aasin
Misc Fixtures :
Electric Contractor(for projects not requiring an EIV Fo�-m)
Use/Nature of Work
Si2.e Material Type # Conn.Type
Sanitary Sewer
Stonn Sc;wer
Water Service
nhiov
11/08/2013 FRI 10: 58 FAX 920 733 2713 Watters Plumbing �002/002
s - p. 1 :
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� c���orogi�kosn
llivision of Jnspeciion Scrviccx
� �1S Cbun:h AvomM
Pp Dos 1130
Osi�kosh WI Y1903-I130
I �.. p0icc 920-Z36-iq50
oi�un wn�ce Fa. 930-t)G-SQR4
� � ����tra� ��ast�l��ti��� V�x��csn���a
. ' 1{�Ne)_.� Y�!�!� � ��....�� _. .
(Flectxical ContxacS:or Nam.e)
��,.�_.!��t�J �.��Sj�.,---�� .. �z-
(Address) 1�(C'.itY) (Sta.fe) (Zip Code)
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have been eontract:ed to perfor.n�eXcctcic ii�statla�.zo».�vozlc:fox',5,��.�r l. ,��,�� ,
(J'�azne of p y cor�tracted to)
al t�,e following ad�ress: _ L 7 � -�--� " � s -' l/�� i �.UT ,
(Address�n�l�ere work will be pexf�rxned)
'I'he nature of t�e work consists of: (Check Onc orDescr�lae the Tlature of Work)
R�connectzon or ncv�,� cireuit Eor repdacement Heating Plant an.d/or A/C Condenser.
� Reconr►eetion,or new circuit t'o�-replacement.Electni�Water�-Xeater ox power vented
water heater.
. Recoxtt�ectioli of the Service Eutrazxce Cable,Meter JBox, alterations to receptacles
� and lxghting�xtures due to sid�ng/sof�1:instaIl�:it�on. Note: Ne�uv Service
� �ntrance Cables wzil require a separate perniit.
Recon»ectxon,or i�e���circuit foe•the Xeplacetne�at of�ati�ex permanez�tXy wired
appliar►ces/.fxh�z-es.
,_ ?`'ew circuit fox��}ae addition �3f!�/C t:o a�n ir�dzvicfual dwel.lzng uni.r(Ixouse ar tY►e
it�divi�ual systexns iu a d.upiex or coa�daminium:�,in,cludiz��required service
e�ectrical outiets.
Other
—�--� J� --�--
Ti�e��a1ue of this work is`5�y�i �.
T hereby veri�Cy this v✓orlc wil.l be perforrned by an en�ployee o�tr�is company and furtl�er��en'tfy
thc reconnection/ii�siaJlatioaa wiIl Ue done in coxnplianec with n�.anufacture�r at�d E�ec#ric code
rcquirements.
, . � , t� � � /� �.� � �
� (S gnature of Cor�apaYay Of:.�cer) (Piint Nanne o� Officer) (.1?ate)
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