HomeMy WebLinkAbout0106544-Plumbing (water heater) � CITY OF OSHKOSH No �os544
,
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD �'"'
ON THE WA�'ER + '�F' 32004
Job Address 1115 E NEW YORK AVE Owner GERRITT J KLEINHUIZEN Create Date 02/23/200$-
Contractor SOPER PLUMBING Category 411 -Residential-Water Heaters Plan
Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Lavatory 0 Lndry Tray 0 Local Waste 0 Wait.St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 Flr/Wst Sink 0 Int Grease Trap 0
Res.Sink 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 0 Beer Tap 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Water Heater 1 Sump Pump 0 Dent.Oper. 0 Hand Sink 0 Urinal 0 Eye Wash Statn 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Piaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature FR/REPLACE GAS WATER HEATER
of Work
Size Material Type # Conn.Type
Sanitary Sewer 0
0
0 :
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
� Parcel Id#
0 1110130000
Valuation $500.00 Plan Approval $0.00 Permit Fees $20.00 ❑ Permit Voided I
Issued By �G� Date 02/23/2004
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
Agent/Owner
Address 2225 BURNWOOD DR Oshkosh WI 54902 -0000 Telephone Number 426-2151
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 Oshko�h
Inspection Services Division R��' � ��E D �
P O Box 1130 --� . �
Oshkosh,WI 54903-1130
Phone:(920)236-5050 FE� ,y ' O�u�/OIu
Fax:(920)236-5084 I II\ I I
� ON THE V/ATER
DEPARTMENT OF
Plumbing Perm����i�c�r�OPMENT
I hereby apply for a pernnt 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 brought to City Hall, Room 205 or mailed to Inspection Services,PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the
normal permit fee,which ever is greater.
OR
If vou are a contractor narticipatinQ in the Permit Fee Account System and have adeguate funds check here
if vou want this nrocessed through vour account n
Job Address ��/A t��/[,�� y�K A�'^VaIUC(Including labor and materials) ��O•�O Date ��/Q—�f�
Owner Contractor s��it �L�„�,��y�
(�.Single Family �Duplex �Multi-Family ❑Rental ❑Commercial QIndustrial
Number of Fixtures:
Bathtub Lndry Standp Dent.Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait.St. Wash Fm
Res.Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater �_ I.ocal Waste Sculry Sink Soda Disp
�Gas❑Elect 0 PwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray Classtm Sink Int Crrease Trap Roof Drain
I.ab Sink Surgeons Sink Ext Grease Trap Stand Rec
P
Plaster Sink Breakrm Sink R.P.Z.Valve Eye Wash Sm
Sterilizer
Electric Contractor OR ❑Electric Installation Verification form attached
(If Replacement)
Use/Nature of Work /1,y�����r,,s�.���
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
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