HomeMy WebLinkAbout0122926-HVAC (boiler)
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OSHKOSH
ON THE WATER
Job Address 916 E IRVING AVE
CITY OF OSHKOSH
No
122926
HVAC PERMIT -APPLICATION AND RECORD
Owner FARZIN FARSAD/F ALMOZAFFAR
Create Date 12/12/2006
Contractor A-1 HEATING & AlC INC
Fuel ~ Gas UOil
System o New
U Forced Air U Radiant
U Electric ~ Hot Water
Chimney Type U Chimney A . Chimney B
Heat Loss U 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
o Not Applicable
U Electric
o Replace
U Steam
U Suppl.
() Direct Vent
o Not Applicable
() Other
Value
Value
105,000
Use/Nature SFR IReplace boiler. EIV provided by Bell Electric.
of Work
Fees: Valuation
$2,597.40
tbnvo
Plan Approval
$0.00
Permit Fee Paid
$49.00
Issued By:
Date 12/15/2006
o Permit Voided I
Parcelld # 1105970000
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
W8D78 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.
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City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, VVI 54903-1130
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 THE WATER
· 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
noma! pemit fee, which ever is greater.
OR
I ou are a contractor artici aNn in' the Permit ee Account S stem and have ade uate unds check here
i VOII want this rocessed throu h our account
JOB ADDRESS 9J6.s If'Vih:; 01- &61; irc:J ~
OWNER ~f~1 dc:n)^f ALtIJ 07-Ot. Pht" :2.-1S-J 'fY2
CONTRACTOR A-I JJ-et:.?ll", 0- fil~ CV",~\J'~JI/},tJ 9b"-7Jy- ~~FJr
~, ~
DATE /(/J/t; 6
RE E' E
DEe 1 2 2006
CHECK ~ ALL APPLICABLE
~USE CATEGORY
, ~ingle Family ODuplex OMulti-Family
DEPARTMENT OF
COMMUNITY DEVELOPMENT
ORental
OCommercial
OIndustria!
FUEL
~Gas
OOil
DElectric OSolid
DSolar
SYSTEM
ONew
DOther
t\aReplace
TYPE
OForced Air ORadiant DSteam ONC OVent DElectric ,f!Hot Water DSupp1.DCon. Burner
IS CHIMNEY BEING LINED %No DYes _ LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
Jb~ ~
\1 V \fl.?!'
(0- \ro- 0-
CIDMNEY TYPE
REA T LOSS
BTU RATE
DChirnney A
o As AP.!2rnved
%A..s Per Pian
~himney B .
WExisting
DVariable
ODirect Vent DOther
ONot Applicable
OOther Value Iv 2 DtlV
DESCRIPTION OF ALL WORK BEING DONE
1J~1 ~~*
V ALUE (Including labor and all materials including light fixtures) $ ,;), S y '7 ' yo
4" Y9' to
r-LECTRICALCONTRACTOR
OR 0 Electric Installation Verification form attached(ff Replacement)
Electrical ins(allmion of new/replacement equipment shall be done by licensed contractors.
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121111%006 ION 13: 56 FAX 1 920 733 2713 WATTERS PLUMBING
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(Addreu) (City) (State) (Zip Code)
hiJve b(,.'Cn COl1tracled to p~rf'qrmcll:Cnic instaUatiQIl work for It-I iJ~ertlh/J. L .1;/4-
At-e. l~uf/ll'( /;I..MvJ.~.p~ I' (Name Ofparty:cohtt~tt:el to)
a(tl~foUowjngaddreS8: <1/11 B /r:VI;'~ &1"" P..~J('I1Jh ";US"-3'!Y2
. (Addrc:ss where work will be performed) ,
Th~ nlllurt of the work con.sists Df: (Check One or Describe the Nature of Work)
_/Reconft..~OIl or."", .i-it for ",,_on, 1I..ti.... P'"" _or AlC C_. .
Reconnet:rion or new elrtlJi! for reptll~=mcnt Electric Water Heat~ or pGwer yfJt1ted
Wa1et heater.
keCOtlneclion of'the S~l'\'ice ~ntrance Cable, MetctBox, alteraCiotlS tel ~et1
IlJ1d ligbtinJ, fixcu.res due tn Aiding I soffit installation. Note~ ~ Service
Entrance Cable$ win require a aepa.-ate pcnnit. :
R.eoon~"tim1 or new circuil for lh.e rephtcement ofother pmnanenClywin:d
appliances llixwres. .
New circujt for 1he addition or Ale to an [""ividu,,1 dwelling unit (~use or d1e
indi\l7dua[ systems ill 11 tlupl~ orcondominium), including required 8~rvi"
clCCtrlellt outl~ls,
_ Oaller
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Tilt: v.duc o(lhi~ work is $..
! hcrc-hy \'crir" Ihis work wm tte f)('*>tmed by an erllploycc: ofthir c::ompany and. ftHther verify
In( rcoonl~c(';OU I itlslal1ation wilt ~ done in c:ompHancc with ltIanut'aetUt'er dfld :EJcetric C01k
tC<juirc/Jitl1tll.
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(Print Name orOffi~r)
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(Date)
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