HomeMy WebLinkAbout0105041-Plumbing (water heater)OSHKOSH
ON THE WATER
.lob Address 735 FOX FIRE DR
Contractor LARRY HANSEN PLBG
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 ADAM R GEURTS
Category 411 - Residential-Water Heaters
No 105041
Create Date 10/30/2003
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/Replace gas water heater that was under warranty.
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 $300.00 Plan Approval $0.00 Permit Fees $20.00 ~J Permit Voided
Issued By
Date
10/30/2003
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 N-1044TOWER VIEW DR GREENVILLE WI 54942 - 8683 Telephone Number
(C)851-6863
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.
City of Oshkosh
Inspection Services Division
P O Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
.9,0. oO
RECE1VED
DE?ARTN1ENT OF
-- CO UNITY D,E.VELO? ENT
Plumbing erm tApphcat on
OJHKOJH
OKi THE WAIER
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.
Job Address "~ ~"~ ]5~, r (~ ~ Value (l.cludinglabor and materials) ~ / ~ Date
Owner Contractor
[~3Sing!e Family [-~Duplex [--IMulti-Family n~Rental [~]Commercial [~lndustrial
Number of Fixtures:
Bathtub Sterilizer Breakrm Sink
Whirlpool Lndry Standp Dent. Oper. Shamp Sink
Lavatory Disposal Dip Well FIrAVst Sink
Toilet Dishwasher Drink Fin Catch Basin
Res. Sink Sump Pump Wait. St. Wash Fm
Bar Sink Ejector/Grind Ice Chest Urinal
ater Ileater ~ Water Soflncr Exam Sillk Gar Dralfl
~'~ [2 Power Vent Sculry Sink Soda Disp
~ow~i E Electric Local Waste
Electric Contractor
Use / Nature of Work
OR E EIV form attached (If Replacement)
Sanitary Sewer
Storm Sewer
Water Service
# Conn. Type
Size Material Type
· 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. Commenmng work without pemfit(s) will result in fees being doubled or $100.00 plus the normal permit fee.
which ever is greater.
OR
Check here if you want this processed through your account []