HomeMy WebLinkAbout0122858-HVAC (furnace)
-0-
OSHKOSH
ON THE WATER
Job Address 136 W 9TH AVE
CITY OF OSHKOSH
No
122858
HVAC PERMIT ..APPLICATION AND RECORD
Owner GERTRUDE H HENCKE LIFE ESTATE
Create Date 12/01/2006
Contractor COMFORT SOLUTIONS LLC/ONE HOUR
Fuel ~ Gas UOil
System o New
~ 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 () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Solar U Solid
o Other
U AlC U Vent
U Con. Burner
U Electric
~ Replace
U Steam
ITSuppl.
() Direct Vent () Not Applicable
() Not Applicable
() Other
Value
Value
Use/Nature ~FRI Replace furnace. EIV provided by Dan Seiler.
of Work
Fees: Valuation
$3,255.00
(Jy;J?VCJ
Plan Approval
$0.00
Permit Fee Paid
$59.50
Issued By:
Date 12/12/2006
o Permit Voided I
Parcelld # 0301100000
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
AgenUOwner
OSHKOSH
WI 54904 - 9794 Telephone Number 920-982-3323
Address
5165 GREEN VALLEY RD
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
12/01/2006 01:01
9202946117
IvlCCONNELLS
PAGE 13
:t 5't)
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City of Osbkosb
Division ofInspcction Services
P.O. Box 1130
Oshkosh., WI 54903-1130
Pbone: (920) 236.5050
Fax (920) 236-5084
(I)
~QlB
HV AC PERMIT APPLICATION
All information after hold categories mu$t beprovidcd.
Incomplete applications will not he processed.
· ApplicBtion(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 pennit(s) will result in fees being doubled or $100.00 plus e
Donnal permit fee, which ever is greater.
OR
JOBADDRESS~' ~l.Q \^-.l q+h A\{~
OWNER :.ba.n.. 'r\e~
CONTRACT;R .~ ~ :t\f>n--h ~
CHECK ~ ALL APPLICABLE
USE CATEGORY
rj T!6ingle Family DDuplex DMulti-Family
DATE~
DRental
o Commercial
OIndustrial
FUEL
"Gas
DOil
DElectric DSolid
DSolar
SYSTEM
DNcw
DOther
Slleplace
,TyPE
JlForced Air DRadiant DSteam DAlC DVent DElectric OHot Water OSuppl. DCon. Burner
[S CHIMNEY BEING LINED~o DYes - LINER SIZE
Note: AIl chimneys shalt be sized. per the BID's being vented.
& MANUFACTURER
CHIMNEY TYPE 1iaChimney A OChimney B DDirect Vent DOther
REA TWSS&s Approved DExisting DNol Applicable
BTU RATE A\s Per Plan DVariable DOther Value
DESCRIPTION OF ALL wo~ BEING DONE \<E1>\(Ue.d rU( c. Clf.e_
~.
\1\U
. .-'t\V I tJ
. 3;) OO}\' ~
VALUE" (Includln2 labor and Dlaterlals) $ . 55 -. \.}:
ELECTRlC~L CONTRACTOR ~ SJ> ~ \~ (" . .. \
o For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must
attached. If Dot attached or not applicable> a separate Electric&1 J:lermit i$ required.
(')
1 104
12/01/2005 01:01
920294511 7
MCCONNELLS
PAGE 14
~
'~'
City of Oshlcosh
})jvi.ion OfIlIS~til)1l Services
;215 Cburch A~I111<'
PO BO;ll; 1130
Osblros" WI S~903-1I30
Offi"'" 920-23~SOSO
1'1'" 1120-Z36-5084
Electric Installation Verification
J)(\V\ ~1~Y
1>(') ~t< lo~
(Address) (City) (State) (Zip Code)
&ve been contracted to perfann electric i:nstaIlarian work for -DV\e \\ou { \-\-1:' aha
(Name of party contracted to)
I (We)
(Electrical Contractor Name)
No..V\o.WCL
WI-
at the following address:
\~ '~ A'-Ie-
'(Address where work will be performed)
The nature of the work consists of: (Check One or Describe the Nature of Work)
~ Reconnection or new circuit for replacement Heating Plant and/or AlC 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 I soffit installation. Note: New Service
Entrance Cables will require a separate pennit.
Reconnection or new circuit for the replacement of other permanently wired
appliances I 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 $
1 hereby verify this work will be performed by an employee of this company and further verify
the reconnection I installation will be done in compliance with manufacturer and Electric code
requirements.
~IL
(Signature of Coropa:ny Officer)
Mctok hLr
(Print Name of Officer)
l!Jkt.f!o&
,
(Date)
5/02