HomeMy WebLinkAbout0106647-HVAC (new circuit)OSHKOSH
ON THE WATER
.lob Address 25 MILL ST
Contractor
Fuel [~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
WESLEY HEATING & COOLING INC
Oil
Owner ROBERT A BUTZLAFF
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
Forced Air I ~J Radiant
Electric I ~J Hot Water
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type IO Chimney A O Chimney B ~ Direct Vent ~ Not Applicable I
Heat Loss I~ As Approved O Existing ~ Not Applicable I Value
BTU Rate I~ As Per Plan ~ Variable ~ Other I Value
No
Create Date
Plan
L~ Solid
106647
02/27/2004
Other
Vent J
50,000 BTU INPUT
Use/Nature DUPLEX / 25A INSTALL DUCANE MPGA 050 B3A DUE TO CRACKED HEAT EXCHANGER, 80% AFUE*EIV SOLAR ELECTRIC
of Work
Fees: Valuation $1,500.00 Plan Approval $0.00 Permit Fee Paid $27.50
Issued By: Date 02/27/2004
Permit Voided J
Parcel Id # 0800940000
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 3220 Basler Ln Oshkosh WI 54901 -0 Telephone Number
920-235-6951
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.
Feb 13 04 10:51a WHC OSH 235 -7550 p,3
City of Oshkosh
t
Division of Inspection Services "� � 2 ,..,
P.a Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236 -5050
Fax (920) 236 -5084 Of ]- KO f H
DEPARTMENT
OF ON THE WIITFR
HVAC PERMIT Witikil CRIME LENT
All information after bold categories must be provided.
Incomplete applications will not be processed.
• 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 $l00.00 plus the
normal permit fee, which ever is greater.
OR
If you are a contractor participating in the Permit fee Account System and have adequate funds. check here
if you want this processed through your account (1
DATE '// 9/ V
JOB ADDRESS 'S A Nat .S T`
OWNER R C B 8t--r 73 v rr cia-FF
CONTRACTOR WCS L EY ,f CR r!A 6 4 0 o0tM) 6
CHECK 0 ALL APPLICABLE
USE CATEGORY
.Dingle Family .upiex ['Multi- Family DRental DConunercial Dlndustrial
FUEL At6as °Electric DSolid SYSTEM °New Replace
DOiI °Solar DOther
g E
reed Air °Radiant ['Steam °A/C °Vent °Electric °Hot Water DSuppl. °Con. Burner
IS CHIMNEY BEING LINED. io °Yes - LINER SIZE & MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY TYPE °Chimney A ErChimney B °Direct Vent °Other
HEAT LOSS DAs Approved igfiaisting [Not Applicable
BTU RATE DAs Per Plan ['Variable °Other Value 4- 00 O Ord / "'POT
DESCRIPTION OF ALL WORK BEING DONE
/n; s r 1,. 7 Mi) f- rvi p&I: os"O ,$ 3 F} . 9a6 - f/ 4
C &-fdA16 l R. - IO4o A
VALUE (Including labor and all materials including light futures) S 15 00. 00
(A
ELECTRICAL CONTRACTOR S 47
0 For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
Feb 13 04 10:51a
Feb ~3 D4
WHC OSH
Electric lustalhtion Verification
FEB 2 6 ~04
DEPART~(ENT OF
!~L~NITY