HomeMy WebLinkAbout0105919-Plumbing (water heater)CITY OF OSHKOSH
105919
No
OSHKOSHPLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address1125 POWERS STOwnerDOROTHY J KRIPPNERCreate Date12/31/2003
ContractorM P KELLYCategoryPlan
411 - Residential-Water Heaters
Bathtub0Shower0Ejector/Grind0Dip Well0F Prep Sink0Gar Drain0
Whirlpool0Floor Drain0Water Softner0Drink Ftn0Serv Sink00
Soda Disp
Lavatory00Local Waste0Wait. St.0Shamp Sink00
Lndry TrayCoffee Maker
Toilet00Clothes Wshr0Ice Chest0Flr/Wst Sink0
0
Lndry Stndp
Int Grease Trap
Res. Sink00Bidet0Exam Sink0Catch Basin0
Disposal0
Ext Grease Trap
Bar Sink000Wash Ftn0
Beer Tap0Sculry Sink
Dishwasher
RPZ Valve0
Water Heater100Urinal0
Sump PumpDent. Oper.0Hand Sink
0
Eye Wash Statn
Site Drain000Standp Rec0
Classrm SinkLab Sink0Plaster Sink
Roof Drain000Ice Maker0
Breakrm SinkSterilizer0Surgeons Sink
Use/Nature SFR/ Replace gas water heater.
of Work
SizeMaterialType#Conn. Type
Sanitary Sewer0
0
0
0
0
Storm Sewer0
0
0
0
0
Water Service0
0
0
0
0
$0.00Permit Voided
Valuation$491.54Plan ApprovalPermit Fees$20.00
Issued ByDate12/31/2003
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.
Date
Signature
Agent/Owner
Address665 N MAIN STOSHKOSHWI54901-4431Telephone Number231-1750
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 <ECE i V ®
O
WI 54903 -1130
Phone: (920) 236 -5050
Fax: (920) 236 -5084 3 i
ON M WA F
DEPARTM ENT
Plumbing Permit AppI DEVELO TL-0'0C21-:F
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 S100.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor Darticivatine in the Permit Fee Account System and have adeauate funds. check here
if you want this vrocessed through your account fl
/ / 25 Value (Including labor and materials)_ � / / _. / Dat / 3 s
Job Address �
Owner ► -, II. _ . . ontractor fit, / • t //y, //ve • '
mgle Family ODup x Multi- Family ORental OCommercial OIndustrial
Number of Fixtures:
Bathtub Lndry Standp Dent. Open. Shang Sink
Whirlpool Disposal Dip Well FWWst Sink
Lavatory Dishwasher Drink Fin Cakh Basin
Toilet Sump Pump Wait. St. Wash
Res. Sink Ejector/Grind Ice Chest Urinal
Bar Sink —*_' Water Softnet. Exam Sink Osr Drain
Water Hester — 1 Local Waste Sculry Sink Soda nap
�G Dfa C Elect 0 PwrVnt Clothes ry _ Hand Sink Coffee Maker
bower Bidet l k
_ _ _ F Prep Sink __ . lee Maker
Floor Drain Beer Tap 5cry Sink She Drain
Lndry Tray Classrm Sink Int Grease Trap Roof Drain
Lab Sink Surgeons Sink Ext Grease Trap Svndp Ito
Plaster Sink Breakrm Sink
Sterilizer
Electric Contractor OR OElectric Installation Verification form attached
(If Replacement)
Use Nature of Work &U Us /
S Material Type # Conn. Type
Sanitary Sewer
Storm AP
Water Service
a /02