HomeMy WebLinkAbout0158875-Plumbing (water heater) � CITY OF OSHKOSH No �5sa75
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 624 JACKSON ST Owner STAR PROPERTIES OF OSHKOSH 2 LLC Create Date 11/21/2013
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
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 Fir/Wst 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 ;SFR/replace water heater
of Work '
'*debit Kitr&Pfeil acct"
i
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcei Id#
0703180000
Valuation $599.00 Plan Approval ___ $0.00 Permit Fees $30.00 ❑ Permit Voided'
Issued By ���. Date 11/2U2013
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.
THU, NOV, 21. 2013 02: 14 PM KITZ&PFEIL OSHKOSH FAX No, 920 236 3348 P. 002
c�ry of o�xo�n - � � . '
Tnspection Services Aivision • �'
P O Box 1130 _ , ���
Oshkpsb,'WI 5490�-1130 • �
P�onc;(920)236-5050 , �
Fax:(920)236-5084 -
. .ow M�wnre
�� Plumbing Permit Application
Z}�by apply for a penmit to do a»d install'the foAowing plumbing on the premis�cs'hereina�ter•descnbed,the worl;to conform to the
Wisconsin Statc Plumb�g Code,iu the perfoimance of which aU partics heteto agree to and are bound by said statutcs.
• Application(s)and fee(s)can be brought to Ciry Hall.,Room 205 or mailed to Inspection 6eri�ces,PO Box 1126,Oshkosb WI
' S4903-1128. Commcncuag wozk wizhout petmit(s)wi11 result in fees baing doublai or$100.00 plus the noriva]permit fee,whioh
6'vPd'1S grCatCL.
OR � •
If vos� are a eontracior a�•ti.ci arirr. dn the Per•mit Fee Aecount S�stem and ha e a.de uate und eh�ck he e
� ou warst this p•ocessed through vour account L1
**Ad,visozp-For applicabJ,e projects, an E'lectrical Instailation VeriS,cation(EI�£orm,sigmed by the Electrical
Contxactor or Homeowner(£oz i.nstallatioms'allo�vved�o be per�ozmed bp the houleownex)must be sabmitted.
with the pe�it application. Applications sabmitted without an EIV�vvhen snch is required;will noti be
� processed£or Permit Issaa.nce and will be zehuued for completion.. ' �
� Job Address ���'Jri��J Valae(�ma�g�r�a��� �1� � Datie ���'��^/3
O�vvner S�Gr- �►'b �o I�S . Contractor �1 oh�l /�Q�1-�'or''(
❑Sfngle Ramilp �Dupleg [JMulti-Familp ORental �]Comcnercial ❑�ndtYStri.al :
ATumber nf�.gtures: �
Be&cub Dieposal Dcmlt Pcn Catc�Hasm
w�rtyoo� rnsbW�na w�.s� � w��m .
Lavatory snmp Puraq . Tco Chesc Uzinal :
Toilet FtiecrodCrrind Bxam Siulc Gsr brain
Ttes.Sink OJazs Soimcs Sculcy Sinlc . Soda Di�p
• Bat Siok I.�w%� Hana sin� � Coffx Maka .
R+atct F�eatu � QotLes Wsta •P prcp Sinlc Co�.ke Mekw
'�Qas�Elect�PwrVnt Serv St�nl: Sfte Drem '
Sidet
• Sho'ave't Bear Tap Iztt Or�ase T1caP Rnof Tha�
' F1oor Dreia � Cla9s�Susk Ext Gzeasc TYbp Staadp Rec .
Lndry Tray Surgeol]s Sink . RPZ'�elva . �'e Wnah Sm
J.ab Sink Breehm S3ak Shemp Sink VJ�Scwa Mlrs
plascer Siuti b�p w� P1r�vV's�Si�c ' neauc�Mem� �
Scenlizer Hnae Bi'bs� ' VJx Usago M.�s , •
2.fsc_ . � , . � •
Fi�SrCS •
Electric Con�ractoz (�or projects not requ.i�ring an EIV Form) �
YJse/Nature of'Work FP �� e• a c��� ✓ .
' Size Matcrial Typc . # , , Conn.:T'ype • � **�x�*,t�rt,*
. P�E TJSE THE :
Sanitary Scwcs . . y�zTZ'& PF�,
Sto�Sewer � �- � . . ACCT. ' �
� . � � '�ank Xau!
VJater Scs��ice '
. . N�
� , o� o�
_.�. ' /5�7� ,
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