HomeMy WebLinkAbout0103641 HOSHKOSH
ON THE WATER
.lob Address 826 MCKINLEY ST
Contractor ADONIS HEATING AND COOLING
Fuel ~J Gas ~
System ~J New
CITY OF OSHKOSH
HVAC PERMIT - APPLICATION AND RECORD
Oil
Forced Air I ~J Radiant
Electric I ~J Hot Water
Owner JOHN E/BERNICE BROWN
Category 500- Residential-Heating & Ventilating
L~ Electric
Replace
L~ Steam
L~ suppl.
Solar
A/C
Con. Burner
Chimney Type I~ ChimneyA ~ Chimney B
Heat Loss I~ As Approved ~ Existing
BTU Rate I~ As Per Plan ~ Variable
Direct Vent
Not Applicable
Not Applicable
Other
Value
Value
No
Create Date
Plan
L~ Solid
103641
08/21/2003
Other J
Vent J
Use/Nature Duplex/replace furnace, install chimney liner.* EIV from Seckar Electric attached.
of Work
Fees: Valuation
Issued By:
$2,425.00 Plan Approval $0.00 Permit Fee Paid
Permit Voided J
$42.50
Date 08/21/2003
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 W2707 County Rd H Pine River WI 54965 -0 Telephone Number
685-0458
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.
10364f
CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 826 MCKINLEY ST Owner JOHN E/BERNICE BROWN Create Date 08/21/2003
Contractor ADONIS HEATING AND COOLING Category 500- Residential-Heating & Ventilating Plan
Fuel L~ Gas J r I Oil I ~ Electric ] ~- Solar ] [_~ Solid I
System [] New I [] Replace. ..... i [] Other J
[] Forced Air bd Radiant j Steam I LJ A/C I Vent f
I'q Electric I ~J Hot Water [ ~ Suppl. ~ ~ Con. Burner I
Chimney Type ~,,~ Chimney A ~ Chimney B O Direct Vent (.~ Not Applicable [
Value
Value
No
Heat Loss ~.~ As Approved ( ~ Existing ~1 Not Applicable
BTU Rate ~ As Per Plan (~ Variable ~ Other
Use/Nature puplex/replace fumaca, instal] chimney liner.* EIV from Seckar Electric attached.
of Work
Fees: Valuation $2,425.00 Plan Approval $0.00 Permit Fee Paid $42.50
Issued By: ,/~ Date 08/21/2003
[] Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
While the City of Oshkos~has/~-~n° authority to~ ~enf°rce easement res trictio r~s~ff._wh~6h-it is not a party, if you perform the work
described
in
this
perm./it'applica/tJo'~ ~¢¢thin an~asem~es the permit applicant to contact the easement
holder(s) and to seqi~re any ne,'~ary/appro~,,Eef,~r¢ starf~ng such activity.
Signature ,--
Address V~7707Cou///ntyRdH 7 pTee~Tv~ncr wi 549650 Telephone Number 6850458
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
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
O/HKO/H
ON THE WATER
HVAC PERMIT APPLICATION
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 $100.00 plus the
normal permit fee, which ever is greater.
OR
[£vou are a contractor participating in the Permit fee Account System and have adequate funds, check here
i£vou want this processed through your account ~
CHECK ~ ALL APPLICABLE
USE CATEGORY
[2Single Family ~i]Ouplex F1Multi-Family
nRental
DCommercial
Ellndustrial
FUEL ~as mElectric F1Solid SYSTEM
mOil []Solar
TYPE
flirted Air r-IRadiant FlSteam F1A/C F1Vent flSt~lectric
IS CttIMNEY BEING LINED F1No {;ii~es - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
[]New ([~l~olace
[]Other
FIHot Water F1Suppl. r'lCon. Burner
& MANUFACTURER /~/~ k C~
CHIMNEY TYPE
I-H~AT LOSS
BTU RATE
[]Chimney A
I-lAs Approved
F1As per Plan
nChimney B ,,i~Direct Vent
ElExisting F1Not Applicable
[]Variable []Other Value
[]Other
)ESCmPT ONOFALLWOm(BEmGnONEflE?; /q
VALUE (Including labor and all materials including light fixtures) $ 3 ~//~ ~ O ~'
ELECTRICAL CONTRACTOR ~'~ ~ ~ ~,4~ f~ ~ ~- ~(>/C'
[] For applicable projects, an Electric Installation Verification form, signed by the Elec~ical Con.actor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
Electric Installation Verification
(Electrical Contractor Name)
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for .7~ OK)t ~ ~/~./-),/(}~_o ,
(Name of party contracted to)
at the following address: ~:>2(_0 po[ 0~ ~[~
(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
..,~ Recormection or new circuit for replacement Heating Plant and/or A/C Condenser.
__ Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
__ Recormection or new circuit for the replacement of other permanently wircd
appliances / fixtures.
-- New circuit forthe addition of A/C to an individual dwelting unit (house orthe
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ / ~-~.0 0
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
(Signature o~ Company Officer)
(Print Name of Officer)
~(Date/
5102