HomeMy WebLinkAbout0102481-Plumbing (water heater)OSHKOSH
ON THE WATER
,Job Address 1214 HARNEY AVE
Contractor JIM'S 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 MICHELELBROEGE
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 102481
Create Date 06/26/2003
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Use/Nature SFR/Replace gas water heater.
of Work
Valuation
Issued By
Sanitary Sewer
Storm Sewer
Water Service
Size Material Type #
$400.00 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 06/27/2003
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 W-6166 GREENVILLE DRIVE GREENVILLE WI 54942 - 0000 Telephone Number
757-5258 OR 757-64(
06/26/2003 08:49 FAX 920 757 6482
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
~ax: (920) 236-5084
JIM'S PLUMBING
OZHKO/H
ON THE WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premise~ hereinafter described, the work to conform to the
Wisco~-'in State Plumbing Code, in the pcrfm-rnance of which all p~-ti~ hereto agr~ to and ar~ bound by said statutes.
Owner f Contraetor
~ingle Family [-']Duplex [-]Multi-Family ["]Rental [-]Commercial ["]Industrial
Number of Fixtures:
Bathtub Lad~ Standp Deat, Open Shamp Sink
Whirlpool Disposal .. Dip Well . FlrAVsI Sink
Lavatory DishwaSher Drink F~ Catch Basin
Electric Contractor
Use / Nature of Work
Saaitary Sewer
Storm Sewer
Size Material
/ /~ ~/~~ ~ [3 EIV form attached (If R~ent)
Waier Service
Application(s) and fee(z) can be brought to City Hall, P. oom 205 or mailed to Inspection Services, PO Box 1128, Oshkosh WI
54903-I 128. Commencing work without permit(s) will result in fees boing doubled or $100.00 plus the n°rmal permit fee,
which ever is greatOr.
Check here if ~ou want this processed through }.our accoun~
"
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-l.J:.: :d.... 1214 HARNEY AVE
Owner MICHELE L BROEGE
( egory 411 - Residential-Water Heaters
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
~
/
Plumbing Permit Work Card
Permit Number 102481
Contractor JIM'S PLUMBING
Create Date 06/26/2003
o
o
o
o
o
o
o
o
o
Plan Value $400.00
Ejector/Grind 0 Dip Well 0 F Prep Sink 0 Gar Drain 0
Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
-
Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Clothes Wshr 0 Ice Chest 0 Flr/Wst Sink 0 Int Grease Trap 0
Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 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
)
Use/Nature
of Work
rFRI R,place gas wale, h...",.
Size Material Type # Conn.Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Date Type F Inspector
/(/B/I b(/ 1 b ~
DatelTime requested:
Access:
Notice Type:
Telephone Number:
Ready DatelTime:
o Reinspect Fee 0 Fee Waived
Requested By:
D Reinspect Fee Paid
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