HomeMy WebLinkAbout2007-HVAC (furnace)
e
OSHKOSH
ON THE WATER
Job Address 1515 MAPLE AVE
CITY OF OSHKOSH
No
123516
HVAC PERMIT -APPLICATION AND RECORD
Owner PA LORlKAMOUA SONG
Create Date 01/29/2007
Contractor A-1 HEATING & AlC INC
Fuel ~ Gas UOil
System o New
U Forced Air U Radiant
U Electric . U Hot Water
Chimney Type D Chimney A () Chimney B
Heat Loss o As Approved . Existing
BTU Rate D As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam
U'Suppl.
() Direct Vent
U Solar [J Solid
D Other
U AlC [I Vent
U Con. Burner'
. Not Applicable
() Not Applicable
. Other
Value
Value
Use/Nature SFR/ Furnace replacement. Bell Electric to do electrical work.
of Work
,
Fees: Valuation
$1,687.12
~
Plan Approval
$0.00
Permit Fee Paid
$35.50
Issued By:
Date 02115/2007
D Permit Voided i
Parcelld # 1600050000
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.
o 02114/2007 WED 16: 34 FAX 1920 733 2713 WAITERS nUMBING
~003/003
I
~i
~
I
I
,
i
""1 ~((Jsi1kiJ.~f.
Di'I.'1Ol1 orl~I,,~ ~J",
USC",.,.,.,,)>A_
~O &1>- "'0
\)ahk..." WI J,oIIIlI). I Dn
Oll\ee nn,ur.-,.,c
f.. ~21'1'''o-3C1".
, l
i
I
l (We) I f,._<..U ....._..JJ.L~, 1-,..; (..
i (Electrical Contractor Name)
I
J {l-a , 13" ~. 1.l..L_.., J1J~114JJ,~
.-(~ddr~S)"- (Clly) (State) (ZjpCode)
, I .
hove; been Fot\lrlctcd to perCorm c:kctl"ic installation work, rOf _ 11:-1 H~(JrfrlrJ, tI- ~G..-.
(~id"~ t Al yi.J ~ V ~ "J. 3..:; - a if> r' (Nmne of pu.r1y contracted ~)
.1 vAt-
at the fotl~wihgadd1css: -L10\ l'IIH1b. X/ail~ If/';- /}11!)e. II,,~ ()Stj
; <Addl'e3s wtierc work will be: pcr(onnc:d)
Electrie .1nstaUntlon Verif1~Qtlon
VI
S-Y'S 2..
i
1
Thl.!' nlllurQ of Ihe work consists of: (Check One or Dcstribe the Nature of Work)
. _.~onneelion or new circuit for replacemen~~d/or Ale COnd~ser.
_..1 Reconnect'ion Qr 21e'W cireu). for replacemeht Eleccr-ic Water Heater or power Vellted
I waler ~ater. '.
--...t Reeonneelion oftlH: $C:1"\Iicc Entrance Cable:., Meter Do". .ltef~tiO"31o rec.epta.clC9
I and lighti~!l fixtures due it) llidingl soffit 1MtaHatioh. Note:; Now Service
-1 El1trance Cables will require II $r;pa.rate pennit.
.- RCC<lnnecUon or n'tw eireuit for the replaccrnenl of oUu:r patrnarlent!)' wired
appliances I fixtures, .
-.... New eireuit (or the addition or A/C 10 un IrtdMdu.at el.welliJ18 unll (house or the
I il"(dlvidual systemG ill a dllpl~x or condominium). iQcluding required B<<ViCIS
i clccU"icnl OUdel!i.
I Other
-r
!
---.,-..
.,.,;,.....-.....',-_.......
.. .
--..-,---
i'lIt: Vi1lilC of\hj~ work is S .
"...--........-..--.
J h.<:rchY ....rri ~y 1his wort< ~itl h~ ()erfonned.bY ~n ~p)o)'ce of this c<lmpany md further veriry
lho,; f~<:t.)nl ~~Cll()n Ilns~l1a\lon wJ11 ~ done In c~plu1ncc: with mlUJufl\ctul'CT end Electric code
l~'~~(Jrcln~llb'
/' I k~
i . '~I ~ -"".
'" . I. ...;.'. ,;c _......_.J..__
. IS 9."1'< or ('4...ny Officer)
i
i
1
I
I ~J, I#- 3" ~ Lj
!
.~d~~ [;;::retJ
(Prll'lt Name: of Officer)
_...:J- Iy'-'Or
(Date)
'/Itl
T .. d
\O;n~ cu::/ , n:;::>~ T
ITn~ln., lll.Tl.I 'HILl Cl~IT'l.I':IlJ TLl
1.',.Jc:~:t:! I nl1:O
or Cl....~
Eod
SOSSSl.l.D261 1 I aND:J ~ HI aNH ~N I IH3H tH
WdSS:~ l.OD2 ~l qa~
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, VVI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
DEPARTMENT OF ON THF WATER
HV AC PERMIT MPIM!ImM1lOR..OPMENT
All information after bold categories must be provided.
Incomplete applications will not be processed,
E
EIVED
JAN 2 9 200!
· 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
nonnal pennit fee, which ever is greater.
OR
I
ee Account S stem and haveade uate unds. check here
JOB ADDRESS ) SIS /JJ'iplt /Jve
OWNER }f Q m ILl ~ X/ () n:;..
CONTRACTOR A-I )/-ee:.7ll.:; (j. fi l~
DATE
//3/07
~
(fJsJ; /(V~ t.,
;)..03 ~ 3 ~v" /})Y//4 Y~Yl~
Cf.l ," ~ ~J,;' JIlt, &J 9:;..v - ;7 J y - J.~ 1;;3 }~
v
CHECK ~ ALL APPLICABLE
USE CATEGORY
~ingle Family. DDuplex DMulti-Family
DRental
o Commercial
DIndustrial
FUEL
~Gas
DOil
OElectric OSolid
DSolar
SYSTEM
ONew
o Other
/2JReplace
TYPE
~orced Air ORadiant OSteam ONC OVent OElectric DHot Water OSuppl.OCon. Burner
IS CHIMNEY BEING LINED ~No DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CIDMNEY TYPE
HEAT LOSS
BTU'RATE
OChimney A
DAs Aplltoyed
DAIs Per Pfan
DChimney B
tlExisting
OVariable
DDirect Vent
DNot Applicable
I)Dther Value
J,t~-cl " a ~~ 1-~ I'~~
I)'Othef'VC.
III, r) t) (J
.
'1'tt1
DESCRIPTION OF ALL WORK BEING DONE
ELECTRICAL CONTRACTOR
/Je l {
l i '%7 . /1-.
,
f 5'0
35'
V ALUE (Including labor and aU materials including light fixtures) $
Cd I:A 3 6'1 '-I
OR 0 Electric Installation Verification form attached(lf Rep~~~l)
Electrical installarion o/new/replacement equipment shall be done by~rfed CO~/'r~gm.
/}}VCUt(l ~ t} 0
\