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Home My WebLink About0103964 HOSHKOSH ON THE WATER .lob Address 1080 N WESTFIELD ST Contractor MARX MECHANICAL Fuel System Gas J ~J Oil New ~ Forced Air Electric CITY OF OSHKOSH HVAC PERMIT - APPLICATION AND RECORD Radiant Hot Water Owner EVERGREEN RETIREMENT COMM INC Category 500- Residential-Heating & Ventilating L~ Electric Replace L~ Steam L~ suppl. Solar A/C Con. Burner Chimney Type I~ ChimneyA Heat Loss I~ As Approved BTU Rate I~ As Per Plan Chimney B ~) Direct Vent O Not Applicable I ~) Existing O Not Applicable I Value ~ Variable ~ Other I Value No Create Date Plan L~ Solid 103964 09/05/2003 Other Vent J Use/Nature of Work Replace furnace, 75m btu input. *EIV form from Beez Electric. Fees: Valuation Issued By: $2,800.00 Plan Approval $0.00 Permit Fee Paid Permit Voided J $47.00 Date 09/05/2003 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 4535 STATE ROAD 91 OSHKOSH WI 54904 -6304 Telephone Number (920) 235-6510 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 Ost~osh, WI 54903-1130 Phone (920) 23 6-5050 Fax (920) 236-5084 HVAC PERMIT APPLICATIO~*p All i~orn~t/on after bold categories ~st be p~ided. · Application(s)and fee(s)can be brought to City Hall, Room 205 or ~iled tX~~ices, PO Box 1128, Os~osh WI 54903-1128. Commencing work without pe~t(s) will result in fe;s ~~or $100.00 plus the normal pemxit fee, which ever is ~eater. OR If you are a contractor participatin~ in the Permit fee ~ccount System and have adequate (unds, check here if you want this processed through your account ~ CONTRACTOR DATE CI-rE, CK [] ALL APPLICABLE USE CATEGORY 'l~TSingle Fmnily I~Duplex IZlMulti-Family E]Rental rq Commercial I3Industrial FUEL Mas [3Electric [Solid SYSTEM CtNew I~eplace ElOil F1Solar [3Other TYPE ~l?orced An' IZlRadiant E]Steam [A/C I~Vent []Electric IS CHIkVI2N~Y BEING LINED [No)~kYes - LINER SIZE Note: All c162nneys shall be sized per the BTU's being vented. ~Hot Water IqSuppl. [3Con. Burner & MANUFACTUIKER ~l~c~-- L~ CHIMNEY TYPE l-rE. &T LOSS BTU RATE [3 Chimney A [3As Approved [As Per Plan ID Chimney B IDExisting F1Variable E]Direct Vent rqNot Applicable F1Other Value ' F1Other DESCRIPTION OF ALL WORK BEING DONE VALUE (Including labor and all materials including light fixtures) $ ~00 ELECmC CO TRACTOR [] For applicable projects, an Electric la~stallation Verification fom~, signed by the Electrical Con~ractoL must be attached. If not attached or not applicable, a separate Electrical Permit is required. 9/o2 Electric Installation Verification ~2~kh Oshkosh WI 54902 have been contracted to perform eleotrio installation work for Marx MechavJcai~ at the following address: 1080 N Westfield St. Village #217. The nature of the work consists of: (Cheek One or Describe the Nature of Wonk) [] Reconnection or new circuk for replacement Heating Plant and/or MC Condenser. [] Reconnection or new circuit for replacement Electaie Water Heater. [] Reconriectioll of the $~:vice Entrance Cable, Meter Box, alterations to receptacles and lighting fixtures due to siding / soffit installation, Note: New Service Entrance Cables will requir~ a ~epacate permit, [] Reccrm¢ction or now circuit for other permanently wired appliances / fixtures. [] Other The value of this work is $150.00 I l~reby verify this work will be perf-ommfl by an employee of this company and further verify the recennection / imtallation will be done in compliance with manufacturer and Elemric code requirements. (Signature of Company Officer) _Cmrv B[esi _nger 09/03/03