HomeMy WebLinkAbout2003-Plumbing (water heater)OSHKOSH
ON THE WATER
,Job Address 909 SCHOOL AVE
Contractor MERTEN PLUMBING
Bathtub 0 Shower
Whirlpool 0 Floor Drain
Lavatory 0 Lndry Tray
Toilet 0 Lndry Stndp
Res. Sink 0 Disposal
Bar Sink 0 Dishwasher
Water Heater 1 Sump Pump
Site Drain 0 Classrm Sink
Roof Drain 0 Breakrm Sink
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner MR/MRS VANG LO
Category 411 - Residential-Water Heaters
0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0
0 WaterSoftner 0 Drink Ftn 0 ServSink 0
0 Local Waste 0 Wait. St. 0 ShampSink 0
0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0
0 Bidet 0 Exam Sink 0 Catch Basin 0
0 Beer Tap 0 SculrySink 0 Wash Ftn 0
0 Dent. Oper. 0 Hand Sink 0 Urinal 0
0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
No 102065
Create Date 06/09/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Install gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$450.00 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
06/09/2003
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 1087 COZY LANE OSHKOSH WI 54901 - 0000 Telephone Number
231-6795
City of Oshkosh
Impeclion Services l~garisian
POBox1130' '
Oshkosh, WI 5490%1130
Phone: (920) 236-5050
Fax: (9_-'20) 236-5084
Plumbing Permit Application
I hereh? apply for a pe~nit to do and install fie :g~uwiag plumbing on the premises hereina~er de~ the work to conform to the
Wisconsin ~te Plumbing Code, ia ~he tx~ox'mance of which all parties hereto agree to and axe bound by said statutes.
· Agplication(s) and fee(s) can be br~Yat to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commeaci~g v~ork without penuit(s) will result in fees being doubled or $100.00 pins the
no, real penni fee, which ever is gxealer.
If you are a corr:trctctor participatin~ i~r rbe Permit Fee Account System and have adequate funds, check here
if you want this ~rrocessed through ~our account [~
JobAddress qO~ 5c~_ ~)~"~_,. Value(i~cludinglaborandmaterials} gS'O. OO
'[~Single Family ~Duplex [~lulti-Family ~]Rental E]Commereial 'J
Date $/7/o3
I-~Industrial
Number of Fixtures:
Baflmxb Lndry Standp Dent. Oper. Shamp Sink
Whirlp~ Disposal Dip Well Flr~Vst Sink
Lav-,m~. Dishwasher Drink Fm Catch Basin
Tofle~ Sump Pump Wait. St. Wash Fm
Re~ S~r,k Ejector/Grind Ice Chest Urinal
Baz Sink Water Soflx~ Exam Sink Gar Drain
Walm' Heater [ Local Waste ScuIw Sink Soda Disp
~C~s 2 Elect Y: Pwr"~rat Clothes Wshr Hand Sink Coffee Maker
Sho~u~ Bidet F Prep Sink lee Maker
Hoer D~ain Beer Tap Serv Sink Site Drain
~Tmy Classrm Sink Int Grease Trap Roof Drain
Lab S~k Surgeons Sink Ext Grease Trap Standp Rec
Plaslex Sink Breakrm Sin~
Ster,]ize~
Electric Contractor
Use / Nature of Work
Sa~l,ay Sewer
Stoma Sewer
Water Service
O-R. ['-]Electric Installfi~tion Verificati6n form attached
(If Replacmaent)
Size
Tyl~e # Conn. Type
3/02