HomeMy WebLinkAbout0103960-HVAC (furnace)OSHKOSH
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
103960
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
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084 ~')/D D .("~ f)~r~(~ ffM
~ ~ ~{ > ON THE WATER
Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to h~spection Services, PO Box 1128,
Os~osh WI 54903-I 128. Commencing work Mthout pemit(s) will result in fees being doubled or $I 00.00 plus the
nonnaI pemit fee, which ever is ~eater.
OR
ff you are a co~tractor participating in the Permit fee ~ccount Sgstem and have adequate funds, check her~
~[you want this processed through your account ~
CONTRACTOR
ATE
CHECK [] ALL APPLICABLE
USE CATEGORY
~gSingle Family 1-1Duplex
[2Multi-Family F1Rental ' . DC0rrm~ercial
[2Industr/al
FUEL )~lGas [qElectric []Solid SYSTEM [1New ~Replace
[] Oil [] Solar []Other
TYI>E
~Forced []A/C []Vent []Electric
Air
EqRadiant
[]Steam
IS CHIiVINEY BEING LINED ENo ~Yes - LINER SIZE
Note: All chinmeys shall be sized per the BTU's being vented.
[]Hot Water ~Suppl.
& MANLrFACTUtLER
[]Con. BHmer
CHIMNEY TYPE
I-TF, &T LOSS
BTU RATE
[]Chinmey A
[]As Approved
[]As Per Plan
[] Chiarmey B
F1Existing
F1Variable
[]]]Direct Vent
I]Not Applicable
[2Other Value
•Other
, scmmo oE worm rune ?0¢_ 160_x;
YALUIg (Including labor and all materials including light fixtures) ,$ (2~x ~0(~~ t. JO
gLECmC COmTRACTOR iSC'
[] For applicable projects, an Eleclzic Installation VeriEcation form, sigx~ed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Pemait is required.
9/02
~9/02/~00~ 21:53 9202317255 ~EEZ ELECTRIO P~GE 85
Electric Installation Verification
(I) (We) Beez Ele~'~ric. Inc.
521 W. 12th Oshkosh WI 54902
have been contm~ted to perf~ electric ~natallafi0n work for ~.Jar~ M~.chanieal,
at the Following address: ~e_ld St. '~qlla~e ff215.
TM nature of the work consists of: (Check One or Describe the Nature of Work)
[] Reconaec'fion or new ckcuk for replacement Heating Plan~ ~fi/or MC C0nd~s~.
R~tion or n~ ci~it for replac~t ~c Wat~ Heart.
K~on of~e S~ce En~ ~le, M~ B~, ~terati~ ~ re~l~ ~
li~g ~es due m fi~ng / so~t ~s~afion. N~e: New S~ Bmr~ce C~I~
~I1 mq~e a sep~aie p~t.
~ KeelSon or n~ ci~ for ~ p~enfly ~r~ ~Iim~s [ fi~res.
The value of this work is $150,00
I hereby verify tl~is work v~lI be l:~fonned by an employee of this compimy and ~arther verify the
reconnection / inaallation will be done tn compliance with manufacturer and Electfie code
rcquh'elll~tll~s.
(Signature of Company Office )
~ Biesin~er Q9t03/03