HomeMy WebLinkAbout0104677 POSHKOSH
ON THE WATER
.lob Address 2500 #B VILLAGE LN
Contractor RASMUSSEN PLUMBING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner BEVERLY M GOSZ
Category 411 - Residential-Water Heaters
No 104677
Create Date 10/08/2003
Plan
Bathtub 0 Shower 0 Ejector/Grind 0 DipWell 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 LocaIWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 Lndry Stndp 0 CIothesWshr 0 Ice Chest 0 FIr/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 SculrySink 0 Wash Ftn 0 RPZValve 0
Water Heater 1 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature CONDO UNIT/Replace electric water heater. *EIV form from Town & Country Electric.
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
0
0
Valuation $450.00 Plan Approval $0.00 Permit Fees $20.00 ~ Permit Voided
Issued By
Date
10/08/2003
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 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 8887 Telephone Number
920-233-6747
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.
10/09/2003 06:12 2336?47
J RASMUSSEN
PAGE 81/82
City Of Oshkosh
P 0 Box 1130
Oshkosh, WI 54903-11
t~hone: (920) 236-5050
Fax: (920) 236-5084
O__/HKO. fH
Plumbing Permit Application
T hereby apply for a permit to do and install the £oIlowi't~g plumbing on the premise5 hcz~i,la,l)/:r described the work m cant'( ~'m to the
Wisconsin State Plnmbing Code. in the perfbmmme o': which al part es hereto agree to and are bmmd by said statutes.
· Al~lieat/on(s) said fee(s) can be Irrought I* CiW I-lall, Room 205 or trailed to Inspection Se~ .ces, ~) Box 1128,
Oshkosh WI 54903-1128. C ' '
..o nmencmg work w thout ~m~t(s) roll ms t t in :fees be ng d >ub ed or $100.00 plus the
n~mal permit fcc, which ever is ~eater.
OR
ff yo*t want th~r~ces.~'ed throu~o~tr account 1~.
Owner ~.=o....~... ..
[~]Single Family [~oplex
[~]Industdal
Number of Fixtures:
Electric Contractor ___ + ~- (--
Use / NaVarre of Work
Material
Sanitary Sewer
Water Scrx4ce
,OR L~Eleetric Installation Verificntioo form
(ff Re~ lace meal)
attached
18/89/2003 0G:12 2336747 J RASMUSSEN PAGE 82/82
.Electric Installation Verification
(Electrical Contractor Name)
(Address) --'~~_~
(State) (g~p Code)
~ave bee~ con~act~ to ~o~ e,ec~c i~s~lla, io~ work ~or
(N~me of party corer<ted to)
The naMm of~m work consists of: (Cheek On~ or D~cdbm ~ Nature of Work)
~ Reeom~.~~ or uew ei~uit for ~lae~ Heath
~ ....... ~ .~w Claret tot repl~-~-.
wate heate ~'~ water Hea~ power vented
-~ Rec°nn<~m~°CthoS~iceEn~an~eCable. MeterBox,~tcration.stO~eptaci~
~d lightiug fixtures due to sing / soffit installa~on. Note: New Se~ce
EnCee Cables will ~uire a s~to P~nit,
~ R~ecfion or new cimtlfl for ~e r~lacem~t of other pennan~tly ~d
appli~ees / fixtm-es.
~ Newcircuitf°rthead~onofMCto~individ~aldwelti.gune(houseor~e
oulJas,
~,_ Other
The value of this work is $_,~....5-& z,,,
I hereby verify tM$ work will be perfi~rmed by aaa employce ofthis company and lhrther verity
the reconnect/on / installation will be done in compliance with manufactm'er and Electric code
requirements.
(Signature of Company Officer)
(l~m Name of Officer) - (Date)