HomeMy WebLinkAbout0101676-Plumbing (water heater)OSHKOSH
ON THE WATER
,Job Address 839 841 JEFFERSON ST
Contractor JEFF'S WATER REPAIR
Bathtub 0 Shower 0
Whirlpool 0 Floor Drain 0
Lavatory 0 Lndry Tray 0
Toilet 0 Lndry Stndp 0
Res. Sink 0 Disposal 0
Bar Sink 0 Dishwasher 0
Water Heater 1 Sump Pump 0
Site Drain 0 Classrm Sink 0
Roof Drain 0 Breakrm Sink 0
CITY OF OSHKOSH
PLUMBING PERMIT -APPLICATION AND RECORD
Owner KELLY/ELIZABETH BURNETT
Category 411 - Residential-Water Heaters
Ejector/Grind 0 DipWell 0 F Prep Sink 0
WaterSoftner 0 Drink Ftn 0 ServSink 0
Local Waste 0 Wait. St. 0 Shamp Sink 0
Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0
Bidet 0 Exam Sink 0 Catch Basin 0
Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Dent. Oper. 0 Hand Sink 0 Urinal 0
Lab Sink 0 Plaster Sink 0 Standp Rec 0
Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 101676
Create Date 05/21/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap __
Use/Nature
of Work
IFPJ
Replace a gas power-vented
water heater.
Valuation $700.00
Issued By ~
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
Conn. Type
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Plan Approval $0.00 Permit Fees $20.00
[] Permit Voided
Date
05/21/2003
In the perfoltCnance of thisx~work, I agree ~.perform all work pursuant to rules governing the described construction.
Signatur~._ ~J~~~ Date
' /~/,-~//~,/~¢~ '~/~' '- Agent/Owner f
Address /¢~2/586 HWY 76 HORTONVILLE~- WI 54944 - 0000 Telephone Number
92O-757-9732
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
OJ'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 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 you are a contractor participating in the Permit Fee Account System and have adequate funds, check here
(f you want this processed through your account N
Job Address ~/~Y~~_ .~.~. Value (,nc,.d,ng,.~,or and materials) ~/J-~ ~ ~ Date
Contractor.
[~l~ntil' [--]Commercial [--]Industrial
ingle Family [~]Duplex [-]Multi-Family
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 Ftn
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater ~' Local Waste Sculry Sink Soda Disp
~-Gas Elec)2~gwrVnt Clothes Wshr Hand Sink Coffee Makgr
Shower 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 Work
OR
[--]Electric Installation Verification form attached
(If Replacement)
Sanitary Sewer
Storm Sewer
Water Service
Size
Material Type # Conn. Type
3/02