HomeMy WebLinkAbout0159049-Plumbing (water heater) � CITY OF OSHKOSH No 159049
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1803 OREGON ST Owner CAROL A WILLIAMS REV TRUST Create Date 12/13/2013
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 FldWst Sink 0 Bidet 0 Site Drain 0 Misc. p
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. � 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
Fioor 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 acct*"
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1404760000
Valuation $660.00 Plan Approval $0.00 Permit Fees _ $30.00 ❑ Permit Voided�i
Issued By �� Date 12/13/2013
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 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 of Osnkosh
losp�ction 5crvices Division �
P 0 Box I 130 �
Oshkosh,WI Sa903-1130
Phone:(920)236-5050 � I I
Fax:(920)23Cs�508a r1
UM TH�WhTEQ
Plumbing Permit qpplication
I hcreby apply for a permit to do and inshall thc fo(lawing plumbing on the prcmises hereinafter describcd,the work oo conform W the
Wisconsin State Plumbing Codc,in the performance of which atl pacties he�eco a�rcc to and are bound by said statutcs.
• Application(s)and fec(s)can he brougfit to City Hall,Room 205 or mailed m inspection Serviccs,PO Aox 1 I Z8,Oshkosh W1
54903-1128. Commencing work wid�out permit(s)will result in fces being doublcd or 5100.00 plus thc nonnal permit fc�,which
cvcr is gret�ter.
OR
lf vou are a contr ctor an rlicFqatingin !hg ,Pgrinit Fee dcq�unt Svs�em c�d have ade_2ua,(gfu�ds,_ehessk here
jf vou wan! [bl,�Rrocassc_aC�hrovgh vo�r��cor�n[ �
**Advisory-Fot appliCable�ojccts� a�q�cctrical Iusrallation Ve�xcatioa(Et�foz�m,signcd by thc Electrica.l
Coa�ractor or I�otneowner(fot�i,astallatiox�s allowed to bc�crfoimed 6y thc homeow�ex)mnst be snbmitted
wit�t�tc�t ap�licauon. Ap�licatitons sabmitted wii�oat an EIV when snch ys rec�nit��d,will not bc
processed�or Perm�it Zs�ance�d w�116e reCarned.for eo�aa,��etion. � -
�ob Address U ��� Valae�r��dmg��or A�a�ra;�s� �� ��U Dste �' ��
Own�r �r'b� ��I ��j��i'�� Contractor U ��
❑Single Fsmily �Anplcx ❑Malti-Fsmily []�t�ntal [)Comroercial DInd 'sl
Number of Fixtures: �
Ba�hwb S�mp Putstp Plaslu Sink Roof Urain
Ch� Snn.Sump/Pump Soullcry Siok Soda Disp
WhI�IpOnl Water SoRenG SCtvitC SINC COfTCC Mkr
Leva�pry Slattdpipc Rcc 3hamp Sink 5i�a Drsin
Toilet Ctierage FA 9urRcons Sink Waitrs Stn
Kit Sink Loral WBStC Stcrilizcr fce Chcst
. p��q� gor gjnk RPZ Velve Comm fu Makcr
Diahvveshet Bteakrm Sink Bidel 1nl Csreoso'Irap
Floor Dr.tin CIRS.erm Si"k Urinel ���T�P
Hosc Bibb � Exnm S'"k BccrT� Eyc Wesh Stn :
Water Fknter _1� F Prcp 5ialc DiDPa Wel1 Dedua Maei --
•C�s L�61cct C7 RvrVnt Floor Sink Drink Fntn Wk Scwcr MU
Clocfics Wshr Flend Sink ' . W:ish P.ntn •. � Wlr Unagc Mtr
Lndry Tray ls�b Sink Catch Basm , Misc Fixlura
Electnic Coatractor(fo�ojects�aot requiring an EIV Form)
U�ee/Nature o�'Work �� S���� ���� �T'��
SiTe Material Typc !�_ _ Conn,Type ;
Sanitary Sewer
Storm Scwer
WA�Cr Servicc
06/09