HomeMy WebLinkAbout0122920-HVAC (boiler)
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OSHKOSH
ON THE WATER
Job Address 522 HIGH AVE
CITY OF OSHKOSH
No
122920
HVAC PERMIT - APPLICATION AND RECORD
Owner CTSB INVESTMENTS LLC
Create Date 12/12/2006
Contractor A-1 HEATING & AlC INC
Fuel ~ Gas UOil
System o New
U Forced Air U Radiant I
U Electric ~ Hot Water 1
Chimney Type . Chimney A () Chimney B
Heat Loss () As Approved . Existing
BTU Rate . As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam
U Suppl.
U Solar U Solid
o Other
U AlC U Vent
U Con. Burner
C) Direct Vent () Not Applicable
() Not Applicable Value
C) Other
Value
105,000
Use/Nature ~FR /Replace boiler. EIV provided by Bell Electric.
of Work
Fees: Valuation
$2,597.40
O$>VO
Plan Approval
$0.00
Permit Fee Paid
$49.00
Issued By:
Date 12/15/2006
o Permit Voided I
Parcelld # 0103090000
.
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
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.
f\
City of Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, VVI54903-1130
Phone (920)236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
~
OfHKOfH
ON THF WATER
JOB ADDRESS S::L 2..
OWNER eft 11 Y'y L
CONTRACTOR A-I
· 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
J ou are a contractor artici atin in' the Permi!-4ee Account S stem and have ade uate unds check here
if you want this processed through your account U .
DATE ///P-J/t.'i
rfI'/J4 live &sJ/f'$~ U{L RE
IJ/'YCtl1/ 6S/- 9S3<J 'I!y- 67'3- j-JI.fi
JI-eC.7,i,t.!J oj..IJ l~ Cv.,. ~~d'~iIJhPI 9,:)..v- 77y - ~~g3 'f DEe 1 2 2006
f7 v
DEPARTMENT OF
COMMUNITY DEVELOPMENT
EIVED
CHECK ii:J ALL APPLICABLE
USE CATEGORY
n ~ingle Family. o Duplex DMulti-Family DRental DCommercial OIndustrial
FUEL )iGas DElectric DSolid SYSTEM DNew 9Replace
DOil DSolar o Other
TYPE
DForced Air DRadiant DSteam DAlC DVent DElectric [(Hot Water DSuppl.DCon. Burner
IS CHIMNEY BEING LINED.P?No DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER_
CIDMNEY TYPE
HEAT LOSS
BTU RATE
~himney A
q,As Ap.,pr<?ved
ftlAs Per Plan
DChimney B
I)lExisting
DVariable
DDirect Vent
DNot Applicable
DOther Value
DOther
DESCRIPTION OF ALL WORK BEING DONE
A O-C).l1
/0.5.. dOc)
~Jt1rv~
~~.rJJ
~n~
1- J- 0
\'V\
V ALUE (Including labor and all materials including light fixtures) $
J-j S 9 7 > if'rJJ
.
;6 t;7 < f) ()
r,ELECTRICAL CONTRACTOR
/jete
cliJ if- J If 62.
OR 0 Electric Installation Verification form attached{lf Replacement)
Electrical installation of new/replacement equipment shall be done by licensed contractors.
12J.U/2006 ION 13: 54 FAX 1 920 733 2713 WAiTERS PLUMBING
~ 0071016
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(Address) .' '(c(ty) , (State)" .. (Zip' Code)
/Jove been clmt1acted 10 perform electric instdt"9ft W~fk rOt . A:~/. Itftrl;.'l!tj,''' A.I L .
. a~'t"'yL Arve,,,'r '(~e'.~tpartjiCtmtt~6:t),
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atl~e (ollowiflg II~SB: S)..2 rfll4-~ ..4:", ~ tfI.r; 1(&(; ~:-.. l~~ ~ ~j 8'1 YN...I,t.-.!) Y6
. (Addre'S$ Wbm: 'Wo~ will,be ~t:ft;itQed/
Tbc nature ge work CO'DSWS of: (Check One'Or'~r,ibe the Nltui'~ ofW~k)
..1 ~eetiml or new c;i~jl fOr 1lq)ia~etJ;terit'Hea.i~gp~BD'~ot.NC 'Coudtaser.
--. RecolUt~tion or "OW 'eirc:u it rot'reptlli:enlCllt BleetJ'ic Walq Heater 01' powm- wawcd
waler h.esJer. . ,
Recon.ttection ~ftbe Service ijutrMce C..~ . Muct .:lCs JIltcntJott!8. to recept80h~e
a"d lighting fixtures due to Riding I Bollif ~laSlat~OJI. NDte~ New Smi..~
Enlraace Cables wiB. require IllCpar,af.e pernik
- ~eeonJlo:tion or new circuit for th.e replacement .o( oCber: pamsnently wm
appliDllces I fixtuTe$.. . .
- New cirwj(. (or Jbe addiUon C?f Ale to an (~l'i4~ dwelling ""it (l1aWl~ Of the
i"dividuat s~tems in a. dupl~ or conddmini1l!J1). including reqUired .ervioe
efcelrical o'Uttets.
_ Otllet
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The: \lalue Qr1hj~ work i~ ~.._
- ~
llle~by Yl:riry fhis wQTk witt be perfOrmed hy anempJoyee Ofth;s.c:oJi1~Y and .fu~ervcrify
the ~lll'\Cctiol1l in:naUa1ion wilf be dcmc in wmpliancc with ~ .. BIlllC;tric code-
r<:.qUlremcJ)\~.
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S;gn~(ure of Company Officer)
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(Print N~e O[ Officer)
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