HomeMy WebLinkAbout0122855-HVAC (furnace & a/c)
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OSHKOSH
ON THE WATER
Job Address 1606 EVANS ST
CITY OF OSHKOSH
No
122855
HVAC PERMIT- APPLICATION AND RECORD
Owner JAMES PITARA N OSTERTAG
Create Date 12/01/2006
Contractor COMFORT SOLUTIONS LLC/ONE HOUR
Fuel ~ Gas UOil
System D New
~ Forced Air U Radiant
U Electric U Hot Water
Chimney Type . Chimney A () Chimney B
Heat Loss . As Approved o Existing
BTU Rate . As Per Plan () Variable
Category 502 - Residential-Both
U Electric
o Replace
U Steam
U Suppl.
o Direct Vent
Plan
U Solar U Solid
D Other
U AlC U Vent
U Con. Burner
() Not Applicable
() Not Applicable
() Other
Value
Value
Use/Nature SFRI Replace furnace & AlC. EIV provided by Dan Seiler.
of Work .
Fees: Valuation
$6,643.00
~
Plan Approval
$0.00
Permit Fee Paid
$110.50
Issued By:
Date 12/12/2006
D Permit Voided I
Parcelld # 1511070000
In the performance of this work, I agree to perform all work pursuant to rules goveming 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
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.
12/01/2005 01:01
920294511 7
IvlCCONNELLS
PAGE 04
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City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, Wl 54903-1 130
:Phone: (920) 236-5050
Fax (920) 236-5084
HV AC PERMIT APPLICATION
All information after bold categodes 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 lllSpection Se("\fices, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pennit(s) will result in fees being doubled or $100.00 plu$ e
nonnal permit fee, which ever is greater.
OR
OWNER
DATE~
CHECI( fa ALL APPLICABLE
USE CATEGORY
r"\ ~ingle Family o Duplex DMultiwFamily
DRental
o Commercial
o lndustrial
FUEL
.Gas
DOil
DElectric OSolid
DSolar
SYSTEM ONew
. ,pOther
J1(R.eplace
TYPE
pIForced Air DRadiant DSteam. ONC DVent DElectric OHot Water DSuppl. Deon. Burner
IS CHIMNEY BEING LINED [SNo Dyes - LINER SIZE
Note: AU Chimneys shall be sized per the B'JU's being vented.
& MANUFACTURER
CHIMNEY TYPE ~himney A DChimney B DDirect Vent
HEAT LOSS . s Approved DExisting DNot Applicable
BTU RA T:E 1<\5 Per Plan DVariable DOther Value
DESCRIPTION OF ALLWORK BEING DONE ~e.~\o...ce.. {U'( y)Qt e..
o Other
~ Pt\~
~
", VALUE (Includlna labor and materials) $ ultf '3 . 00
ELECTRICAL CONTRACTOR ~ ~ \e"
o For appHcable projects, an Electric Installation Verification form, si~ned by the Electrical Contractor, must
attached. Ifnot atte.ched or not applicable, a separate Electrical Permit is required.
J'~j
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~12/01/_2005 01: 01
920294511 7
MCCONNELLS
PAGE 05
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City DfO~bko9h .
D!,,;s\QIlllflnspec(ioll Services
:l15 CblIl'Cb Aoenuc
,"0 Box 11.30
OsbkOllh Wl S~1l03-1130
DffiG" 920-236-5050
Fax !nO.13G-~084
Electric Installation Verification
I(We)~ .1:xm Se~\~{
(Electrical Contractor Name)
~D fu)( &~
(Address)
Ho..hQWa..
(City)
WI-
(State)
have been contracted to perform electric installation work for
("
(Name of party contracted to)
at the following address:
\kOte f-'\Io.f\t; St
(Address where work will be perfonned)
The nature of the work consists of: (Check One or Describe the Nature of Work)
A Reconnection or new circuit for replacement Heating Plant and/or NC 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 $ .
I 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.
M~~
(Signature of Compa;ny Officer)
.N/dtO/~ vJ;(
(print Name of Officer)
IO!ZD[OCR
(Date)
5/02