HomeMy WebLinkAbout0159166-Plumbing (water heater) � CITY OF OSHKOSH No 159166
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3865 WESTERN DR Owner THOMAS O KING Create Date 12/30/2013
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 Flr/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
UselNature SFR/replace water heater
of Work
'debit Kitz 8�Pfeil accY*
�
i
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1261030100 �
Valuation $595.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided I�
Issued By � Date 12/30/2013
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 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 �4
continue if the inspection is not performed within two business days from the time the project is ready. 3
i
s
02/07/2008 12:34 9202363348 KITZ & PFEIL HDWE_ PAGE 02/02
City of Osbkosh , �
Inspcction Services Thvision �
P O Dox 1130
Oshknsh,WI54903-1�30
Phone:(920)236-505Q �� �
Fa�::(920)236-5084 .
oN Tnc wATx¢
� Plumbing Permit Application
I hcreby apply for a permit to do as�d install th�foJlowing plumbing on the premises hercinafter dcscribed,tb,e work to confoz�n to the
. Wisconsin Stat�Plumbing Code,in the pe�ozmaace of which all parties hereto agzee to et�.d are bo�md b}�said statutes,
• Applica�ton(s)az►d fee(s)ean be brou�ht to C�iry Hall,Koom 205 or z�aailed to Inspection Serviccs,PO Box 1128,OshkpsJ�VJI
54903-I�28. Commcncing work without pezznit(s)will zesult in£ees being daubled ox 5100.00 plus tbe non�al pesmit feP,whieh
ever is greater.
OR
I u are a contracc r artici atin in the Permt ee Account. Si�srem and have ade vate �ads ch ck here
N��ou waMt this processed throuQh vour atcount Q
**Advxsory-Fnr applicab�e projec�s, an Electti�eal Installation Vezi�eabiou(EI�form, signed b�'tbe Elechacal
Contxacto�or Homeown.er(for inista]Iations aJ.lowed to be performed by the ho�oaeownez)mnst be snbmitted
witb.the permit applzcation, Applicationis submitted withoat az�EIV w�en sach is rec�uired, w�ill not be
� processed�nx Permit Issaa�ee aAd wi11 be retnrned fox completiom.
,� � (,� � y �J" s ' O Date ��` � ���
Job A.ddress � l►� �t.Value(I.o��u�ins��oraoamac�,;a]S)
Owner � M Coz�txactor �
�S�.gle Famil� []Dupl�e �iV�ul�ti-Fa.ncd�F []R ❑Cofritri2Kc�a� Tudustria�
. 1�Tnmber n�Fiatares: �
aat�,u� D;3yosal Drink Fm Catch Basin
V✓hirlpool Disbaeaher Vdait.St Wasb Fm
La�+atorY 5ump Pt1mp lce Cb� lirin�l
'�'oila Ejecmr/Griud Exam Siak C)az Azain
Res.S+nl: water Soitrier Swlry Si»]�c Soda lli�
Bat Sink I.ocal v�'asrs I3�d 5i.oir � Goff�Nfalccr .
Weccr l�eater � Clotbes Waka P Fxep Smk Comm.lce Meker
�Gas�J�lect PavrVpt Bidet Serv Simk Site Draizt "
S�w01 BoeX Tsp Int C�ease Trap Rovf AKaifa
Floar Ikain Clas�m Sink Exc G�ca.ee IXaP Ste�odp Rec .
I.Adry'Ii�Y Surgaoee Sink R3.Z.Va1ve Eyc R'esh S4l
I.�Siak Hree�[w SiNc 6hemp Siok Wt Sewer Mas
Piasur Siwb, bip t�Ve.11 Fbdwet Sink Dedact Meiers
Stenl�zer H2OSE��bs WG Usege Mtrs .
MisC. .
Fixltues
Electric Col�ixactoz(�'oz� jects uot requirilu;an E1V k'o�
Use/Natuze of'Work
Size Material �ype # , Cozln.Type **�r*,t**x�:t
Sanitary Scw�r PI�A.SE USE 'I'HE
KITZ�& P�'.EIL
StozAa Scwer � � ACGT. '
� � 'Thank Yau!
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