HomeMy WebLinkAbout0122925-HVAC (boiler)
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OSHKOSH
ON THE WATER
Job Address 1129 VAN BUREN AVE
CITY OF OSHKOSH
No
122925
HVAC PERMIT - APPLICATION AND RECORD
Owner GRETCHEN C HAFEMEISTER
Create Date 12/12/2006
Contractor A-1 HEATING & AlC INC
Fuel l!'J Gas UOil
System o New
U Forced Air U Radiant
U Electric l!'J Hot Water
Chimney Type D Chimney A () Chimney B
Heat Loss D As Approved . Existing
BTU Rate . As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam I
[JSlJPpl-i
U Solar U Solid
o Other
U AlC U Vent
U Con. Burner
() Direct Vent
. Not Applicable
() Not Applicable
() Other
Value
Value
Use/Nature SFR /Replace boiler. EIV provided by Bell Electric.
of Work
Fees: Valuation
$3,738.35
~
Plan Approval
$0.00
Permit Fee Paid
$67.00
Issued By:
Date 12/15/2006
o Permit Voided I
Parcelld # 1605290000
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
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.
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City of Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, VVI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HV AC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
~
OJ~1KOJH
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
nomal permit fee, which ever is greater.
OR
J
ee Account S stem and have ade uate unds. check here
DEe 1 2 L~006
DEPARTMENT OF
R\f'il tlJIM U j\J IT~ J1 ~\lj: LOFM ENT
OComm€r-eml -1'11 l.::m1Ctusrria
DATE
JOB ADDRESS /1). 9 V~f\ I; I.f ve /'f /.lite OJ 4ltir~ ~
OWNER &--re it:. 4 ()i1 flC/i"'e.Ifl-<:'f~!Jif (\ J-3 /; -. J <1 b 2
CONTRACTOR A-I J!'€C.1);'~1 d- fi l~ t..'v,-. ~IJ'~i1I},t:J 9.)~"-7 J'j - 2-"cf:J
v \>
~E
CHECK 6:'J ALL APPLICABLE
/'"""\ USE CATEGORY
, ~Sing]e Family. ODuplex
OMulti-Family
ORental
FUEL
)1Gas
OOil
oNew
DOther
~eplace
DElectric oSoIid
DSolar
SYSTEM
TYPE
DForced Air ORadiant DSteam oAlC oVent OElectric rJHot Wgter oSuppI.DCon. Burner
IS CHIMNEY BEING LINED tQNo DYes _ LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CIDMNEY TYPE
HEA T LOSS
BTU RATE
OChirnney A
DAs Ar.12r0ved
~As Per Pfan
OChimney B
~xisting
OVariable
ODirect Vent ~ther ,lJI/L
ONot Applicable
OOther Value ;r-O,. "00
DESCRIPTION OF ALL WORK BEING DONE
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V ALUE (Including labor and all materials including light fixtures) $ 3,. 7 .3 ~ . :IS
~LECTRICALCONTRACTOR
/~/J-?/O' 6
EI
E
\04 6
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/l (7.f)L?
OR 0 Electric Installation Verification form attached(ff Replacement)
Electrical installalion of new/replacement equipment shall be done by licensed COn/raclors.
c)b IP 3'1:),2
12/11/2006 ION 13: 55 FAX 1920 733 2713 WATIERS PLUMBING
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~013/016
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(Address) (City) (SLate) (Zip Code)
~vc been CillllNlcte(f 10 perform clcc:trie inawlJlition work rOf -'i....J f.J~"rf'lf!J '" Ao/ L
,,'rtt+Jtci# fI~ -k",e,''sjl'''' (Name ofpart)' conrncred to)
,uthefolltlwift8Il1ddress: --..!1.1-.-1 (/4!V1 d",r",AJ h-I/'t.. I'f'H,~h J..,3J-19'~
, (Addre~ where work wItt be perfl:mned)
Thv. nalurc ohile wo,* consistS of: (Chedc One or .t>cscribethe Nature or Work)
- ~cecmftectl.. Ot""'" ,"noW I fo, "'l'l"".."..tli.lIlill8 Plant """"or /VC C.hd.......
- RecoMection or new cinmiC for rcpl&ccrnent Electric Wat~ H~er or power Y<1lfed
W'ler bcatJ:~.
R.eeormecltonofthe Sendee EnCruwc Cablco. Meter 8ox, alterat;o.lo rcc:ep~
anf.J UghUng fbtures due to d(jing I 5Ofl'it lnmflacion. Noto: New ScnJ(;C
Entrance Cables wHJ require II $llp4ratc permit.
Recoru'lcction or new cireuit forth.e rcpll!~em~t o{othcrpermanenrly Wittd
appliances I fixtun!s.
New cirtuit for the addi(jon or Ale to un i~Jtyjdual dwt/U"t unil (boWie or ffle
individu.al systems in n dupZex orcondomimum}, inc:lnding requ.iTed Berri~e
clCCtncnl O\lltets.
~ <'htler
--......-...._._4.---.... ___.....
The vnllle oflhi$ work is $.._.
- ..
---'
I hereby \"<:rify Ihis work wHJ be pet(onnc:d by an employee oftb14 C01'!1p.a1ly and ful1hor verify
the reCQllnL'Criot\ I installation will be done in tQfnptiancc witb manufacturer and E1<<tJic: code
rcquironm~t$.
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' (~ign..lur~ 0" COfl1})any om~er)
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(Print Name QfOfficcr)
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