HomeMy WebLinkAbout0101224-Plumbing (water heater)OSHKOSH
ON THE WATER
.lob Address 144 HIGH AVE
Contractor GARTMAN MECHANICAL
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner NORTHERN TELEPHONE&DATACORP
Category 411 - Residential-Water Heaters
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 0 F Prep Sink 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0
Lavatory 0 Lndry Tray 0 LocaIWaste 0 Wait. St. 0 Shamp Sink 0
Toilet 0 Lndry Stndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
Res. Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 SculrySink 0 Wash Ftn 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 101224
Create Date 05/02/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature COMM/Replace gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$550.00 Plan Approval $0.00 Permit Fees
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$20.00
Date
05/02/2003
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 520W SOUTH PARKAV OSHKOSH WI 54902 - 0000 Telephone Number
920-231-5530
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
ON THE WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes.
· Application(s) and fee(s) can be brmght to City Hall, Room 205 or mailed to Inspection Sei'vices, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without p6rmit(s) will .result in fees being doubled or $100.00 plus the
vnrmal permit fee, which ever is greater.
OR
If you are a contractor participq, t_in_ g in the Permi,t F~ ee Account St,stern and have adequate funds, check here
if you Want 'this probes~ed through ~our ~c~un~F
Job Address. , \qk~. Lb.. -o k%~. Value (In¢,uding ,a,o~dr~iterials) ~C) -
Owner ~X.~O~'~r'l,.k.X~'\ -.._~~.~ Contractor ~.J'~~
r--]Single Family r-]Duplex [--]Multi-Family [-]Rental ~Commercial [-]Industrial
DateL~!
Number Of Fixtures:
Batht'~ .................. i~nd~'~dp ........... Dent. Oper. - ..... Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait. St. Wash Ftn
Res. Sink Ejector/Grind Ice Chest Urinal ,, ,
Bar Sink Water Sofmer Exam Sink Gar Drain
Sh~o~ter Heater / Local Waste Scurfy Sink Soda Disp
eras Q Elect· E PwrVnt Clothes Wshr Hand Sink Coffee Maker
Bidet F Prep Sink Ice Maker
Floor Drain
Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Int Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink
Breakrm Sink
Sterilizer
Electric Contractor
Use'/Nature of Wor~O ~
Sanitary Sewer
Size Material
r-]Electric Installation Verificatign form attached
(If Replacement)
Type # Conn. Type
Storm Sewer
Water Service
3/o2