HomeMy WebLinkAbout2002-HVAC (furnace) CITY OF OSHKOSH
OSHKOSH HVAC PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 615 PROSPECT AVE Owner MATTHEW M/ALICE WESTPHAL
Contractor MARTENS HEATING & COOLING Category 502- Residential-Both
Fuel L~J Gas I ~ Oil I ~ Electric
System [] New I [] Replace
L~ Forced Air I ~ Radiant I L-I steam
[~-~ectric I L~ Hot Water t L~ Suppl.
Chimney Type ~ Chimney A (-.2 Chimney B ~ Direct Vent
Heat Loss ~ As Approved O Existing (_~ Not Applicable
BTU Rate ~..~ As Per Plan (.~ Variable I~l Other
No 98795
Create Date 10/25/2002
Plan
~ Solar
Ld NC I
~]~--on. Bumer I
Not Applicable J
J Value
J Value 60m
J~]--Solid
[] Other j
L-J Vent
Use/Nature
of Work
Iw FR//Install furnace,
nar (AD).
ductwork & 2 ton central air. *EIV form from MY Electric received on 10/23/02. Work not Started as of 10-25-02 per
Fees: Valuation $3,545.00 Plan Approval $0.00 Permit Fee Paid $59.00
Issued By: Date 11/25/2002
[] Permit Voided
In the performance of this work, I agree to per{orm all work pursuant to rules governing the described construction.
Signature Date
Address P.O. BOX 108
Agent/Owner
WAUKAU WI 54980 - 106 Telephone Number (920) 685-6244
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVA PER IT J ATION
All infor~tion after bold categories must be provided.
Incomplete applications will not ~ 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
If you are 0 controctor participating in the Permit £.ee.dc~oun_t S_.vstem and have adequ_a_t_e_ funds_, ch~c_k__hgre~
i.f_you want,tili~ processed through your ~¢count ["']
DATE
CHECK I~ ALL APPLICABLE
.USE CATEGORY
"~:{figle Family
r"lDuplex l-IMulti-Family
J~Rental [] Commercial [] Industrial
FUEL ~(Gas ElElectric DSolid SYSTEM J~ew EIReplace
FIOil I:lSolar ElOther
TYPE
~t~Forced Air EIRadiant v1Steam ~I/A/C FlVent EIElectri¢ Elliot Water r-ISuppl. FICon. Burner
Note: All chimneys shall be sized per the BTU s being vented,
CHIMNEY TYPE '? F1Chimney A FIChimney B I-1Direct Vent
HEAT LOSS 12JAs Approved ~Existing I-IN0t Applicable
BTU RATE l-lAs Per Plan 12Variable FlOther Value ~Q/Dt'~) ~
DESCRIPTION OF ALL WORK BEING DONE ~-~~Z ~'~ %~ ~Z~//~'
mOther
YALUE (Including labor and all materlal~ In¢ludi.g light nxtures) $ ~&~ q~ 0 0 = ~6~, ~0
ELE~?~C~ CONT~CTOR ~ OR ~ Electric Installation Verification form a~ached(lf R. lacc~nt)
3/02
I (We) MY
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903-1130
Office 920-236-5050
Fax 920-236-5084
R C IV D
OCT 2 J
· OEPARTMEN
Electric InstallationVerlfi _ u£., vt:LOPM£NTToF
Electric Corp.
(ElectricalContractorName)
1512 Rugby St. Oshkosh WI 54902
(Address) (City) (State) (Zip Code)
have been contracted to perform electric installation work for/4/~r4 7LJ/ ~,/(/~.f //0 d~/
(Name of party contracted t~>)
at the following address: ¢/~-' ft/"O,.J/Z9 ~ '7-//j~ t~' , (Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
~econnection 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.
Reconnection or new circuit for the replacement of other permanently wired
appliances/'fixtures.
New circuit for the addition of A/C to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value of this work is $ $ 500.00 or Les s
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 of FomPay.. __~__ ~' Officer)
Eric Youngbauer /b /23/ ~J2
(Print Name of Officer) (Date)
5/02