HomeMy WebLinkAbout0123540-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 1355 CEDAR ST
CITY OF OSHKOSH
HVAC PERMIT -APPLICATION AND RECORD
No
123540
Owner LILLIAN G RADTKE
Create Date 02116/2007
Contractor DRUCKS PLUMBING & HEATING CO IN(
Fuel ~ Gas UOil
System D New
~ Forced Air U Radiant
U Electric U Hot Water
Chimney Type D Chimney A () Chimney B
Heat Loss D As Approved . Existing
BTU Rate D As Per Plan . Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
~ Replace
U Steam
U Suppl.
o Direct Vent
U Solar D Solid
D Other
U AlC 0 Vent
U Con. Bumer
. Not Applicable
o Not Applicable
o Other
Use/Nature SFR / REPLACE FURNACE, EIV SIGNED BY TRIUMPH ELECTRIC
of Work
Value
Value
Fees: Valuation $4,425.00
Issued By: ~ W
Plan Approval
$0.00
Permit Fee Paid
$77.50
Date 02116/2007
D Permit Voided I
Parcelld # 1204340000
In the performance of this work, I agree to perform all work pursuant to rules goveming 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
POBOX 355
MENASHA
WI 54952 - 355 Telephone Number 920-426-2654
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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Oftice 02D-:l36-snso
FIPI ~D4J6-5014
,
Electric. Installation Verification
(l) two) -WI WI" ~':2me&\~~i~e)
~ti?-,O W. WCILI!IlJP jtf"(J'(" 4f1f1LGJ<J;0 wT
(Address) (City) . (State) (Zip Code) 6 v'i 1'1
have been conttacted to perfonn electric: installation work for ])r UG Ie ts e4,1VU,b I uy IfC'a..f1 ~ If
(lianw of parry contracted to) --I
at the folloWing address: 1355 Ced((y st. ash [(os br 5tf 901
(Address where woi!< will be performed)
i '"
The nal.Ure oftbe work consists of: (Check One or Describe the Ne:ture of Work)
X RecoIUleetion or. new circuit for replacement Heating Plant mcit'er AJe-€emdSf!Q8Fr
R~.()J')t)eotion or new circuit for replacement Electric Water Heater.
Reco1U1ection OIthO Serviea Erttranee Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding I soffit installa.tion. Note: New Service Entrance-
Cables will require a separate permit
Reconncction at' new circuit for other permanently wiTed. appliancos I fix:t\tt~.
Other.
The value of this work is $ /J 010 ,0 ~
t hereby verify this work will be performed by an employee of tb.i$ company and further verify the
reconnection I installa.tion will be done in compliance with manufacturer and Electric cOde
requirements.
(s;!:2~~!:t:.:~
w.....-
(Print Name of Officer)
(Date)
"
~
OJH<OJH
ON THE W^TER
Division of Inspection Services
215 Church Avenue
P.O. Box 1130
Oshkosh, WI 54903-1130
Fax # (920) 236-5084
Phone (920) 236-5048
FEB 1 6 2001
"J, --t If ,. 0 1
#bl3~)'
HVAC PERMIT APPLICATION
All
fields/information after bold categories must be provided.
Incomplete applications will not be processed.
DATE 6Jk 4/07
I I
)3~5 Cedd(~+~
OWNER [I f r { VL V1 (( a d -f ]( e _
CONTRACTOR t?Y'uc~k:I(' P{uVlA1;>:j +H"'tlh~
CIRCLE ALL APPLICABLE
JOB ADDRESS
DUPLEX
MULTI-FAMILY
COMMERCIAL
INDUSTRIAL
FUEL OIL ELECTRIC
SYSTEM NEW ~
TYPE (7';;~ RADIANT
ELECTRIC HOT WATER
SOLAR SOLID
OTHER
STEAM Alc VENT
SUPPL . CON. BURNER
IS CHIMNEY BEING LINED n 0 LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
MANUFACTURER
CHIMNEY TYPE
CHIMNEY A
CHIMNEY B
DIRECT VENT
(~
HEAT LOSS
AS APPROVED
NOT APPLICABLE
BTU RATE
AS PER PLAN
OTHER VALUE
NATURE OF WORK:
K ~ p ) 00 L.Q IV {' lA (( C-i
VALUE (Including labor and materials) $ Y. 'iuS -
ELECTRICAL :CCI4'TRACTO;&,' -I (r V VVl 'Ph & ( e 6- .{ V ~('
Electrical installation of new/replacement equipment shall
contractors.
be done by licensed
+11 <;'''
Valuation
Fees
$ 0 to $1, 0 0 0 . 0 0 ........_.........._._._._...._._................_............._................_._......._._._..................._.....$ 20 . 00
$1, 000 . 01 to $10, 000 . 0 0..........._..............................._._..................._............._._.......................$ 20 . 00 for firs t
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01' to $25,000. 00................._._........................................_._...............................,..:......$155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $ 25 , 000 . 0 0 .................................................._..................._................_._................_............._........$ 3 05 . 00 plus, $ 0 . 50
per $100.00 ,valuation or part thereof
· Submit payment with application. Failure to pay within 30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
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