HomeMy WebLinkAbout0122828-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 1229 ELMWOOD AVE
CITY OF OSHKOSH
No
122828
HVAC PERMIT -APPLICATION AND RECORD
Owner PHILIP AlJESSE A KARPOWITZ JR
Create Date 12/08/2006
Contractor VANS HEATING & AlC INC
Fuel l!':.I Gas UOil
System D New
l!:J Forced Air U Radiant
U Electric U Hot Water
Chimney Type [) Chimney A [) Chimney B
Heat Loss [) As Approved . Existing
BTU Rate [) As Per Plan o Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam
U Suppl.
. Direct Vent
U Solar U Solid
D Other
U AlC U Vent
U Con. Burner
() Not Applicable
o Not Applicable
. Other
Value
Value
45,000
Use/Nature ~FRlReplace furnace, 3" chimney liner. EIV provided by Concept Services Inc.
of Work
Fees: Valuation
$3,170.00
Q)~
Plan Approval
$0.00
Permit Fee Paid
$58.00
Date 12/08/2006
Issued By:
D Permit Voided I
Parcelld # 1201430000
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
525 BUTLER ST
DEPERE
WI 54115 - 5426 Telephone Number 920-336-2816
--
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, VVI54903-ll30
r\ Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
ON THE WATER
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be 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 vou are a contractor participatinf! in the Permit fee Account Svstem and have adequate funds, check here
if vou want this processed throllf!h vour account n
DATE~
JOB ADDRESS 1 d>d<4 .f:\ i'r\ LPD~ ~
OWNER ~~ ~\\\D~~\L}-
CONTRACTOR.~ Wa~~
CHECK 0 ALL APPLICABLE
,~...E CATEGORY
r\~ingle Family DDuplex
$~%\ CD
~~~\- ~
DMulti-Family
o Rental
o Commercial
o Industrial
FUEL
rxGas
SOil
DElectric DSolid
DSolar
SYSTEM
DNew
DOther
~eplace
.T~E
~rced Air DRadiant DSteam DNC DVent DElectric DHot Water DSupp1.DCon. Burner I.
IS CHIMNEY BEING LINED DNo MYes - LINER SJZJ!1' J?/rJry& MANUFACTURER Frey / L-.
Note: All chimneys shall be sized per the B"fU's being vented.
CIDMNEY TYPE DChirrmey A o Chimney B )gjJ)irect Vent o Other
HEAT LOSS DAs Approved ~xisting DNot Applicable
BTU RATE DAs Per Plan DVariable )&Other Value Y 5 pt:C)
DESCRIPTION OF ALL WORK BEING DONE~\(1).e. Q fU~Vfl f1~ J
~
. 1 \~fl,L) ~
. . cD d \ W' ^~ ~
VALUE (Ineluding labor and all mateclals ;nelndlng lIgbt flxtnr..) ~ \ \ ?')%
ELECTRICAL CONTRACTOR OR ~Electric Installation Verification form attached(lfReplacement)
r\ Electrlcal installation of new/replacement equipment shall be done by licensed contractorj
3/02
FROM CONCEPT SERV ICES _
FAX NO. 920-336-8697
Mar. 18 2003 03:01PM Pi
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(ltJ lilt w tR
Cily tlf~QSh
DivisiOn oflnspectioll ~~cs
21:5 Church ,,~u=
POBox 1130
Osldcosb WI 54903-11;30
OITJCe 920-236-.5050
Fax 920-236-5084
Electric Installation Verification
wI 541f.j
(State) (Zip Code)
,
have been contracted to perfonn electric installation work for l/1t"'l..J !J.1?/I..}.",.t 9 t (cpL(jI\.3
(Name of party contracted to)
at th~ following address: jaaq E\ rY':\~ -~-
(Address where work will be performed)
----4035
(Address)
C'OVl ((?PI ~5(Jfvl(f?.3
. (Electrical Contractor Name)
}r~y f7 - :JJe !kRe J
I (City) .
Inc.,
I (We)
The nature of the work consists of: (Check One or Describe the Nature of Work)
-:i.. Reconnection or new circuit for replacement Heating Plant and/or Ale Condenser.
Reconnection or new circuit for replacement Elec1ric 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 Setvice
Entrance Cables will req~ a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of Ale 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 $ )00,00 .
-I hereby verify this work will be perfonned by an employee of this company and further verify
the reconnection / installation win be done in compliance with manufacturer and Eleptric code
(11)4
(Signature ofCornpany Officer)"
J)Av;-d 'Y:JRoJ
(Print Name of Officer)
1d-~6LQ
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