HomeMy WebLinkAbout0105017-Plumbing (water heater) � , - CITY OF OSHKOSH No 10501 5��"v�i�
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OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER n�c=.r-
Job Address 406 W 7TH AVE Owner DOUGLAS/SANDRA LACROIX Create Date 10/29/2003
Contractor JNL PLUMBING Category 411 -Residential-Water Heaters Plan
Bathtub 0 Shower 0 Ejector/Grind 0 Dip Well 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 Local Waste 0 Wait.St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 0 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 Flr/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 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Water Heater 1 Sump Pump 0 Dent.Oper. 0 Hand Sink 0 Urinal 0 Eye Wash Statn 0
Site Drain 0 Classrm Sink , 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink I U Sterilizer 0 Surgeons Sink 0 Ice Maker 0
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Use/Nature FR/Replace power vented water heater.
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 $500.00 Plan Approval $0.00 Permit Fees $20.00 ❑ Permit Voided�
Issued B�— Date 10/29/2003 �
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In the performance of this work,1 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 =
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described in this permit application within an easement,the City strongly urges the permit applicant to contact the �
easement holder(s d to secure any necessary approvals before starting such activity. }
Signature � Date �'"�7��� 4
AgenUOwner
Address 1111 Minnesota Oshkosh WI 54902 -0000 Telephone Number 232-7270
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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.
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City of Oshkosh
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 thd 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 Fou are a contractor participatin~ in the Permit Fee Account SFstem and have adequate funds, check here
if Fou want this processed through Four account ~]
Job Address L/0 ~ t..d '~ 'ff'''''~ Value (n~cl,,di.glabor a.d.~t~als) 500
Owner Contractor J ~ ~ fo/atm ~ ,,'/.~q
Single Family [~Duplex [~Multi-Family [-]Rental [--]Commercial !
[--]Industrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Oper. Shamp Sink
Whirlpool Disposal Dip Well Flr/Wst Sink
Lavatory D/shwasher Drink Fen Catch Basin
Toilet Sump Pump Wait. St. Wash Fen
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink Water Softner Exam Sink Gar Drain
Water Heater I Local Waste Sculry Sink Soda Disp
[] Gas [3 Elect ~.PwrVnt Clothes Wshr Hand Sink Coffee Maker
Shower
Bidet F Prep Sink Ice Maker
Floor Drain
Bear Tap Serf 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 R;P.Z. Valve Eye Wash Stn
Sterilizer
Electric Contractor
Use / Nature of Work
OR
[-]Electric Installation Verification form attached
(I£ Replacement)
Sanitary Sewer
Size Material Type
# Conn. Type
Storm Sewer
Water Service
7/03