HomeMy WebLinkAbout0159211-Plumbing (water heater) SG�NFo
� � CITY OF OSHKOSH rMM10Z�i No 159211
OSHKOSH PLUMBING PERMIT -APPLICATION AND RE
ON THE WATER
Job Address 820 W 5TH AVE __ Owner DIANNE L LAPINE Create Date 01/06/2014
Contractor MERTEN PLUMBING&HEATING INC Category 410-Residential-Interior 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. 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 p
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/Water heater -- -- - -�
of Work
�
� �
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
0604630000
Valuation $795.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided'
Issued By ps Date 01/06/2014
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(sl anri t�secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address 1087 COZY LN OSHKOSH WI 54901 -1404 Telephone Number 231-6795
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 specifed 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 af Os6�sh
It�specdon Servixs Division �
P O Box 1130 �
Oshkosh,WI S�l903-1130
Phone:(920)236-5050
Eax:(920)236-5084
ON THE WATER �
�t#1��3i1� �1�1#� ���CB�ltN1
j�Y�Y�a per�uit to do aod install tt�e follovrin8 P��B��P�����b0d,the warlc w canfocm to the
Wisconsin State Plumbing Code,in the perfora�ance of which aii parties hereto ag�ee to and are bound by said statutes. .
� Application(s)and fee(s)can be brought W City Hail,Room 205 or mailed to Inspedio�n Services,PO Box l 128,Osh�osh WI
54903-1128. Commencing work without permit(s)witl resutt in fees being doubled or 5100.00 plus the nom�al pertrut fee,which
t�er is greater.
OR
If vou are a contractor articipati� en the Peruiit Fee Acco�ent Svsteru and have �doQ�ate fu»ds check here
if vou want this nrocessed thro�gh vour account (1
**Advisory-For applicable projeds,an Elecxdcal Insmllation Veri6catio�(EI�fi�m,si�ued by the IIecbricat
Contiacbarr or Hon�eo�rner(�ar instaHations�o�ei t�n be pedammd by tht homeawaerj m�st be�d
With the penmit applicstiion. Applications s�ed�vith�t aa EIV when s�ch is r���i,w�l not be
lrucessed fur Pe�mit iss�aace an��be rrt�nnel far ca�pletian.
dob Addr�.s g �� (l� S �ll . Vaine�����a�S� .S, �� te
Owner �11 I a Y111 G LA f i Y1 e Contractor e • � ' �
�Singk F�mitY �DaPlez 011+�u16-Ramily QRc�tal OCommerrnl �
Number of F'iztares:
Bathwb Sump Pump Plastrr Sid� Roof Ihain
Show�er Saa Sump/Pump Scullay Sink ��
Whiripool Water SoRener Savice Sinic Coffa Miv
l.avatory Standpipe Rec Shau�Sid� Site Ikain
Toilet Garagie FD Surgaoat Siok Waitrs Sm
Kit Sinlc C.ocal Waste Steriliarr Ioe Chest
DisPosal Bar Sink RPZ Valve Comm Ice Makc
Dishwasha B�m Smt Bida tet(?�save Trap
Floor Lhain Classrm Sink Urinal Ext Cmage Ttap
FIose Bibb �3sam Smk Bexr Tap �p��$�
W��a = F Prep Sidc Dipper Well p�ty,�
�D Gas❑Eloct�PwrVm Floor Sink Driol�Fnm Wtr Sewe7 Mtr
C1Whes Wshr Hand Siolc Wash Fnm Wtr Usage Mtr
�'TBY Lab Sinl� Catc6 Basin Misc FnWua
Eloctric�ontrxctor(for pro�ects not roqairing�n EIY Form)
Use/Natnre of Work
size Material Type # eom.Type
Sanitary 3ewer
Storm Se�vec
Water Service
06/09