HomeMy WebLinkAbout0104824-Plumbing (water heater)OSHKOSH
ON THE WATER
,Job Address 833 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 DAWN L MARWITZ
Category 411 - Residential-Water Heaters
No 104824
Create Date 10/16/2003
Plan
Ejector/Grind 0 DipWell 0 F Prep Sink 0 Gar Drain 0
Water Softner 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
LocalWaste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
ClothesWshr 0 Ice Chest 0 FIr/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 RPZ Valve 0
Dent. Oper. 0 Hand Sink 0 Urinal 0 EyeWash Statn 0
Lab Sink 0 Plaster Sink 0 Standp Rec 0
Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use/Nature SFR/Install gas power vented water heater.* Existing electric outlet.
of Work
Sanitary Sewer
Storm Sewer
Water Service
Size Material
Type
#
0
0
0
0
0
0
0
Conn. Type
Valuation $700.00 Plan Approval $0.00 Permit Fees $20.00 ~J Permit Voided
Issued By
Date
10/16/2003
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 N2586 HWY76 HORTONVILLE WI 54944 - 0000 Telephone Number
920-757-9732
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.
C,_ity of (Sshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
O/HKO/H
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
lf you are a contractor participatin~ in the Permit Fee Account Svstem and have adequate funds, check here
if you want this processed through your account
Job Address
Owner
$ingleFamUy I--1Duplex F1M/uu ti-FamUy I--IRenta W1Commercia
[-]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well FlffWst Sink
Lavatory Dishwasher Drink Ftn Catch Basin
Toilet Sump Pump Wait. St. Wash Fm
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Soltner Exam Sink Gar Drain
Water Heater ~ Local Waste Sculry Sink Soda Disp
~as [3 Elect t Wshr Hand Sink Coffee Maker
Clothes
Shower Bidet F Prep Sink Ice Maker
Floor Drain Beer Tap Serv Sink Site Drain
Lndry Tray Classrm Sink Iht Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Standp Rec
Plaster Sink Breakrm Sink R.P.Z. Valve Eye Wash Stn
Sterilizer
Electric Contractor
OR
~-]Electric Installation Verification form attached
(If Replacement)
Use / Nature of Work
Sanitary'Sewer
Storm Sewer
Water Service
Size
Material Type # Corm. Type
7/03