HomeMy WebLinkAbout0112633-HVAC (boiler)
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OSHKOSH
ON THE WATER
CITY OF OSHKOSH
No
112633
HVAC PERMIT - APPLICATION AND RECORD
Job Address 637 JEFFERSON ST
Owner
RAMSEY/BARBARA KAGAK
Create Date 01/27/2005
Contractor A-1 HEATING & A/C INC
1,(1 Gas 1 1 Oil
Fuel
1 1 New 1
System
U Forced Air U Radiant
1 1 Electric 1,(1 Hot Water
Chimney Type () Chimney A 0 Chimney B
Heat Loss 10 As Approved 0 Existing
BTU Rate 10 As Per Plan 0 Variable
Category 500 - Residential-Heating & Ventilating
Plan
1 1 Electric
1,(1 Replace
1
1 1 Other
1 U Vent
1
1 1 Solar
1 1 Solid
U Steam
1 1 Suppl.
U A/C
1 1 Con. Burner
0 Direct Vent
. Not Applicable
. Not Applicable
. Other
Value
0
Value
Use/Nature SFR/ Replace Boiler, EIV provided by Bell Electric - NO CHIMNEY LINER BEING INSTALLED---
of Work
Fees: Valuation
$3,069.00
Plan Approval
$0.00
Permit Fee Paid
$51.50
Issued By:
Date 02/09/2005
U Permit Voided 1
Parcelld # 0402190000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Agent/Owner
Address
W8078 HILLCREST CT
HORTONVILLE
WI 54944 - 0
Telephone Number
920-779-8838
---
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
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Elktrlc Installation Verltieatlon
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(P.leclrk.~1 Contractor Nome)
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(Address)
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(City)
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(Name of p811y cotltracted to)
h~vc been ",'ntraClcd to perform electric in.tullation work for
3t the following address:
6',37 Z){!tf'.{'$cN JI- f2~~/(C)' &..b
(Address where work will be p~rfonned}
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The nature of the w<>rk eOßníst9 of: (Check One or O..cdbc the NalUN: of Work)
__Ý-Reconncction ar new circuit tor replacement Heating Plant andlor NC Condel1Jl:I'.
- Reconncclìon or new circuit for (CpIMemenl Electric Water Healer or power Yen~
Wàler hCàlcr.
-.-. RCCOIUtcctíon o1'thc Service Entrance Cable, Metor Sox. altcrntio\I!J to rooe )laI:lcs
WId lighting fi~tllres due to ~jdi )S I noffit in.tallation, Note' NeW SelVioc
Entrance Cilbles will n.'"quit'l: a GCparale permit.
-,., RccomJcction or new circuit for tile rcpl ccment of other permanently wi~
appliances I fi~ture$.
""--'" New circuit for the addition of AIC to an Individual d\wlli'lg unit (hollse or the
individual systenlS i~ a duplex or clmdominium), jllcl\ldin!!~uired aerviee
electrical outlets,
- Other
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The "~I\lc ar\hi~ work is $....................__.
I hcreby verify this work wiil he perfomled by an employee ortois compall)' and further verify
the reCOtU1<,ctlon J il\stallaliol1 wi!] be daM in compliance with mlUJufaclureT and Etc<:ltí" "ode
rcqUil"(:""'llts,
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(Sign.t",." ()rCOtl'pal1y OHicer)
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(Prill' Name orOfficer)
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./: ¿;y.. ,7$
(Dale)
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