HomeMy WebLinkAbout0122915-HVAC (boiler)
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OSHKOSH
ON THE WATER
Job Address 802 EASTMAN ST
CITY OF OSHKOSH
No
122915
HVAC PERMIT -APPLICATION AND RECORD
Owner JAY ULOWELL UMARION J BRUGGINK
Create Date 12/12/2006
Contractor A-1 HEATING & NC INC
Fuel ~ Gas ~ UOil
System D New
U Forced Air U Radiant
0- Electric I ~ 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 NC U Vent
U Con. Burner
. Not Applicable
U Electric
~ Replace
U Steam
U Suppl.
() Direct Vent
() Not Applicable
() Other
Value
Value
80,000
Use/Nature Duplex / Replace boiler (services both units). EIV provided by Bell Electric.
of Work
Fees: Valuation
$3,738.35
O~
Plan Approval
$0.00
Permit Fee Paid
$67.00
Issued By:
Date 12/15/2006
o Permit Voided I
Parcel Id # 1003030000
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 restrictigns 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.
~,
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, VVI 54903-1130
Phone (920)236-5050
Fax (920) 236-5084
~
OfHKOfH
ON THF WATER
HVAC PERMIT APPLICATION
All information after bold categories 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 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
nonna! pennit fee, which ever is greater.
OR
/ ou are a contractor artici atin in' the Permit check here
you want this rocessed throu h our account
JOB ADDRESS 3D J... Eo S ttVIiu1 Sf
OWNER l-.ove LL IJ rt1 8J /11 k.
CONTRACTOR A-I JI'€6'.1,;';j (j- ./J.l~
DATE
///;;7/06
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Os Ii Iros ~.
.SJ.7 - II YD
L.(NI ~ ,el, ~ Mh t'J 9,)v'- '7 j y - ~: &5 }....
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r
w'".",
L:
CHECK Ii:J ALL APPLICABLE
r\ USE CATEGORY
~ingle Family. ODuplex
DMulti-Family
FUEL
riGas
OOil
OElectric OSo!id
OSolar
R' E' C iF"j
'" ". ~~
~ \. : ~,.J I",... '
DEe 1 2 2006
DEPARTMENT OF
COMMUNITY DEVELOPMENT
ORental
I o Commercial
o Industrial
SYSTEM
d(eplace
DNew
o Other
TYPE
DForced Air DRadiant OSteam DAlC OVent OE!ectric ~ot Water DSupp1.DCon. Burner
IS CHIMNEY BEING LINED [)No DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CIDMNEY TYPE
REA T LOSS
BTU RATE
OChirnney A
OAs Ap.ntoyed
)2f<\s Per Pfan
OChimney B
!;BExisting
DVariable
DESCRIPTION OF ALL WORK BEING DONE
-
& MANUFACTURER
DDirect V ent ~Other /I vc
DNot Applicable
DOther Value J);/ r d iJ 0
u
~~i I
. '?
~\ ~ 1/\\
~ d~
\
A~1 /r~a1@rv.J:4--
V ALUE (Including labor and all materials including light fixtures) $
,"'\ELECTRlCAL CONTRACTOR
4r [{-
cfrJ 1ft (1 S'3 '2.
3, 732S' 3S
.r
I'd 7 , ~!v
OR 0 Electric Installation Verification form attached(lf Replacement)
Electrical installation a/new/replacement equipment shall be done by licensed contmclors.
12/11/2306 MON 13:53 FAX 1 920 733 2713 WATTERSPLUHBING
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Ele~trJe Installation Verlileatlon
t (We) ~._.._.Al.~?-"'; c.. ~b >>- a 53 2.
rE.l~trical Contractor Name)
.__-'!:J?.:.._.A 0 X 1Ll....... 1!1.."~,Jh~ Iv' , .. .r" ',5 t..
(Addms) (City) (Slato) (Zip Code)
hove been CPftt.tae\ed 10 perform et<;ctric ift.1I&l1/etiotl work for .A-I 1t'fl#tJ.f4i" .tV'~A
LD ~~ t, l.. t1 f'114j lit J( (Name of party cOn\ractcdto)
:ttthefollowlngaddre~: 34)'?.. 13~~11n'~'.5"" PJ",!~.J6 .r17-1/~'i?,
(Address where wort< wnt bcl*!onned)
The natqrc: of the work consists of: (Check One or Dqcribc the Nature of Work)
-. ~cconncction or new circuit rar rep1GCemenlHealina Plant end/or AJC Col2dooler.
R~eetio" or new circuit for teplat:entenl ElectrSc Water Neate!' 01' power vented
water beater.
Reconnection 01: the Service entranc::t:l Olblc. Meter Box,lIttetrlliC1UJ to TCceptlleh:s
IJnd liabtinll fb:~l'C! due 10 Riding I $GRit msc.nali.on, Note; New Se,...ic:c
el1tranee Cllbles wilt 1"equire a s~.rate: permil.
R ceoM cc:don or new circujt for th,e replacement of other pc:mwu:ntly wired
applilVJC:cs J fi.lC.bm:s.
Nl:w circuit for ~11e addition Q f Ale to Bn j",dMduul dwmU"S uldt (house or the
individual s~e1\'S in II dl.lplcxoreot1dominium). in<::Juding required aervicll
dcclri<:~1 outlets.
O1het
. :
-~
The v(\l~1C orlhi. work is S.._
I hereby \'cri ry lhh work will he pcrronned by an employee of this company and further verify
Ihl.: ~CUlll1cctiQl\ J il)~l8I1aljon witt be done in cotnJlUance with rt1anuf~un:r and Eleettic cock
r~qtl'rcll'{,l'tS.
.~..."."....
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(Sit~nalor~ e>fColnl'l1l1)' Offic:or)
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-15e.III"'rtol~ j:'~'<--:l;"~
(Print Nwnc of Officer)
-
12.-. (i-'O'~
- ,
(Date)
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