HomeMy WebLinkAbout0113454 H
e
OSHKOSH
ON THE WATER
CITY OF OSHKOSH
No
113454
HVAC PERMIT - APPLICATION AND RECORD
Job Address
1838 MOUNT VERNON ST
Owner
MYLES/ALFRIEDA LEUTHOLD TRUST
Create Date 04/13/2005
Contractor A-1 HEATING & A/C INC
1,(1 Gas 1 1 Oil
Fuel
1 1 New 1
System
l..j U
Forced Air Radiant
1 1 Electric 1 1
Hot Water
Chimney Type () Chimney A 0 Chimney B
Heat Loss 10 As Approved . 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.
. Direct Vent
U A/C
1 1 Con. Burner
0 Not Applicable
0 Not Applicable
. Other
Value
0
Value
80000
Use/Nature SFR/ Furnace replacement, EIV provided by Bell Elect. No chimney liner being installed.Where an appliance is permanently disconnected from
of Work an existing chimney or vent (CN) , the CN shall be resized as necessary to control flue gas condensation in the interior of the CN and to provide
he appliance or appliances served with the req. draft.
Fees: Valuation
$2,400.00
Plan Approval
$0.00
Permit Fee Paid
$41.00
Issued By:
Date 04/13/2005
U Permit Voided 1
Parcelld # 1503280000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Agent/Owner
Address
W8078 HILLCREST CT
HORTONVILLE
WI 54944 - 0
Telephone Number
920-779-8838
---
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
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Electric lnstal1ation Verification
I (We)_.
l3ed. SL~(+r,,'l.:._.._...-
(E1~ctrícal Co.ntractol' Name)
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..L3Þ3..........J!lt4w.I:y_.f1L.J12~.!1f:.:J¡.f1.... Iv'I £'li-tl
(Address) (Cily) (State) (Zip Code)
(¡'wc been contracted 10 perfO1T11 electric installation work for -t!::L Nt«J.I~J. <II AI'- ) , t-ifJi
(NDtnc ¡¡fparty co~tl'l<ct"d 10)
at the following address: _ï12J..?:/.. JJ...y(¡/o' 11136 f)AJ{ 57 .!1..!tII(..t, ),31- 1!aJ..f2.
(Addre~$ w)¡er~ work wilt be performed)
lb.enal"te ofth. work ccmi.t. or: (Check One or Describe the Nature of Work)
þcconncClion or new circuit for replacement Healing Plant >1ndlor A/C Condcn~cr,
-- Rcconncction or new circuit for replacement Electric Water Healer or power vømed
water heater,
- ReconnecÜo\1 ofthc Service Enl.ra:1ce Cable, MelerBox, altemliorls to receptacles
and Iightitl<1 fixtures due to siding I soffit ill$tall~\Uon, Note: New Service
Enlmnce Cables will require n separate permit,
.- Recoo.neetion or neW circuil for tho replacement of other permanently wired
appliances! fixtu..,,;,
- New circuit for the addi\Íon of A/C to an IndiVIdl1QI dwelling tmit (housc or the
individual ~ystemg in a dLlplex Qr condominiLun), including required service
electrical oullet$,
- Olher
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The volue of this wQrk is $...
1 hereby verify this work will be performed by wt employee of this company and further verify
the rcco~nectiO!l1 instul1alion will he done in compliance with m¡¡nu!Aeturer and Electric code
requirements,
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,¿A:.. /".e..(;..'é,¡; ..
., ( '¡gnature of Company Officer)
~~f:..l, ck...E~!;,J.:~1......m-
(Print Name oramcer)
c(.. (".. IN)';"''
(Date)
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