HomeMy WebLinkAbout0123406-HVAC (boiler)
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OSHKOSH
ON THE WATER
Job Address 1370 MARICOPA DR
CITY OF OSHKOSH
No
123406
HVAC PERMIT - APPLICATION AND RECORD
Owner TODD SrrERI A MOlDREM
Create Date 02/02/2007
Contractor THOMPSON HEATING AND COOLING S
Fuel ~ Gas UOil
System o New
U Forced Air U Radiant
U Electric.. ~ Hot Water
Chimney Type D Chimney A . Chimney B
Heat loss U As Approved . Existing
BTU Rate () As Per Plan C) Variable
Category 500 - Residential-Heating & Ventilating Plan
U Solar U Solid
o Other
U AlC 0 Vent
U. Cdn. Burner
() Not Applicable
U Electric
~ Replace
U Steam
U Suppl.
() Direct Vent
C) Not Applicable
. Other
Value
Value
105,000
Use/Nature SFR / REPLACE BOILER. 2/5/07 Quality Electric provided EIV for this work. No electrical permit issued.
of Work
$2,440.00
Plan Approval
$0.00
Permit Fee Paid
$47.50
Fees: Valuation
Issued By:
Date 02/02/2007
o Permit Voided I
Parcelld # 1312460000
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
901 OTTER
OSHKOSH
WI 54901 - 0
Telephone Number 920-426-3095
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, WI 54903-1130
Phone (920)236-5050
Fax (920) 236-5084
RECEIVED
~
OJHKOfH
ON THE WATER
FEB 0 2 20lH
DEPARTMENT OF
COMMUNITY DEVELO~MENT
HVAC PERMIT APPLICATION
All infonnation after hold 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
normal permit fee, which ever is greater.
OR
Ifvou are a contractor Darticipatinf! in the Permit fee Account System and have adequate funds, check here
if yOU want thisTJrocessed throuf!h your account n .
DATE
JOBADDRESS /~/O 1/;1~ UJj74- .
. OWNER M2Y/)I/tz~U- /fhGI>I~'
CONTRACTOR. 77-/-6/1--1 f 8(JAJ /-h--:;-;?4-T7 ~7
CHECK fa ALL APPLICABLE
~~E CATEGORY
~ingle Family DDuplex
DMulti-Family
DRental
OCommercial
DIndustrial .
FUEL
~Gas
DOil
DElectric DSolid
o Solar
SYSTEM
DNew
DOther
~Replace
TYPE
DForced Air DRadiant DSteam DAlC DVent DElectric ~Hot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINED !SirNo DYes - LINER SIZE
Note: All chimJl.eysshall be sized pe;{he BTU's be~g vented.
& MANUFACTURER
CHIMNEY TYPE DChimney A ~hirnney B DDirect Vent DOther
HEAT LOSS DAs Approved Bfu.isting DNot Applicable ~
BTU RATE DAs Per Plan DVariable ~er Value /0.) /m
DESCRIPTION OF ALL WORK BEING DONE 4~€ gl~~
VALUE ~fO~ r?
. . . - 'tllLtf'l (;:u~el C!-,
ELECTRICALCONTRACTOR -~/:t" ^ ^ ^ ": " ^ ^ -- ^
o For applicable projects, an E1 ctric Install tion Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required.
9/02
~
OfHKOfH
ON THE WATER
City of Oshkosh
Division ofInspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903-1130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Veri:Ocation
I (We)
Q\A-0\' ~'1 5 f--e c ~~ c... .
(Electrical Contractor Name)
3; $1)
( Address)
G f~h P r- 00 Ie.. L rt
(City)
(State) (Zip Code)
/C3/l'1 to $o~S !ir:A-i-l/v,r
(Name of party contr'acted to)
have been contracted to perform electric installation work for
at the following address: I 3 70 M;Jv'" J (C-' ()? ~
(Address where work will be performed)
The nature ofthe work consists of: (Check One or Describe the Nature of Work)
~ 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 ofthe Service Entrance Cable, Meter Box, alterations to receptacles
and lighting fixtures due to siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.
Reconnection or new circuit for the replacement of other permanently wired
appliances / fixtures.
New circuit for the addition of NC to an individual dwelling unit (house or the
individual systems in a duplex or condominiu,m), including required service
electrical outlets.
Other
The value of this work is $ . V~ 0 (')
I hereby verify this work will be performed by an employee of this company and further verify
the reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
~~--t=;=e~ OIANJ-oP
fficer) (Print Name of Officer)
8-- S'-Cl7
(Date)
5/02