HomeMy WebLinkAbout0122854-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 513 CENTRAL ST
CITY OF OSHKOSH
No
122854
. HVAC PERMIT - APPLICATION AND RECORD
Owner ROBERT J ROElS
Create Date 12/01/2006
Contractor COMFORT SOLUTIONS llC/ONE HOUR
Fuel I......) Gas UOil
System o New
l!J Forced Air U Radiant
IT Electric U Hot Water
Chimney Type Ie) Chimney A () Chimney B
Heat Loss KJ As Approved () Existing
BTU Rate o As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Solar U Solid
o Other
U AlC U Vent
U Con. Burner
() Not Applicable
U Electric
o Replace
U Steam
U Suppl.
. Direct Vent
. Not Applicable
. Other
Value
Value
Use/Nature SFRI Replace furnace. EIV provided by Dan Seiler.
of Work
Fees: Valuation
$2,900.00
a~
Plan Approval
$0.00
Permit Fee Paid
$53.50
Issued By:
Date 12/12/2006
o Permit Voided I
Parcelld # 0701530000
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
5165 GREEN VAllEY RD
OSHKOSH
WI 54904 - 9794 Telephone Number 920-982-3323
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
920294611 7
MCCONNELLS
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PAGE 03
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City of Oshkosh
Division ofInspectioll Sc:rviccs
P',Q.Box 1130
Oshkosh, VVJ54903.l130
Phone (920) 236.5050
fax (920) 236.5084
~
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HVAC PERMIT APPLICA T~ON
All information after bold categories must be provided.
Incomplete applications will ,",ot be processed.
. Apl?lication(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 e
nonnal pexmit fee, which ever is greater. .
OR
JOB ADD
OWNER
DATE 10--:<..3}-Oto
CHECK 0 ALL APPLICABLE
r"\ ~E CATEGORY
'. FSingle Family DDuplex
OMulti~Family
ORental
o Commercial
o Industria]
FUEL
ilGas
DOil
OE1ectr.ic DSolid
DSo)ar
SYSTEM
DNew
o Other
~eplace
TYPE
,*,orced Air DRadiant DSteam DAle OVent o Electric OHot Water DSuppL Clean. Burner
IS CHIMNEY IIEJNG LINED ~o DYes- LINER SIZE & MANUFACTURER
Note: All Chimneys shall be sized pOT the BTU's bein2 vented.
CHIMNEY TYPE OChironey A OChimney B ~jrect Vent o Other
REA T LOSS DAs Approved DExisting ;KNot Applicable
BTU RATE OAs Per Plan DVariable DOther Value
DESCRIPTION OF ALL WORKBElNG DONEsep~ Wf\A ce
VALUE (Including labor and materials) $ Jqro. (f)
\bt, P ~ ·
I \\ ~~ t<t ~0 I!
,\g ~ f}. !
U-~ '
\
ELECTRICAL CONTRACTOR
(\ 0 For applicable projects, an Electric Installation Verification fonn> signed by theE1ectrical Contractor> must
.ttached. If not .meh.. 0' not .ppHe.ble, · 'ep"",'e El",'ricaI Permit is required. l'
1 104
;1
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12/01/2005 04:14
920294511 7
MCCONNELLS
PAGE 02
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City II! O;hkosh
PiviS10Il ofl~ctlO'li~
215 Cl1l1l:Cb AW:lIIIC
PO Bolt 11.30
OsbkOBll WI ~90}-1130 .
015"" 92/l-.2JIS-SOSO
FlIlt 920-;l3iS.s084
I (We)
Electric Installation Verification
1cu~ Sei ley
'j) '. .
{/.,0 _ toKu;3
(Address)
(Electrical Contractor Name)
N\uXKJ.t&
(City)
lJ:L
(State)
,5Lf9Lf!l
(Zip C~de)
The nature of the work consists of: (Check One or Describe the Nature of Work)
f. Reconnection or new circuit for replacement Heating Plant and/or Ale 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.
Reconnect1on or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of NC to an individual dwelling unit (house or the
individual systems in a duplex or condominium), including required service
electrical outlets.
Other
The value oftbisworkis $
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.
[YUjJhj liikfJM
(Signature ofCompa:ny Officer)
Ifl{'JJgJ~ \ -Da do
F (Print Name of Officer) . . (Date)
5102