HomeMy WebLinkAbout0123589-HVAC (boiler)
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OSHKOSH
ON THE WATER
Job Address 1922 COLUMBIA AVE
CITY OF OSHKOSH
No
123589
HVAC PERMIT -APPLICATION AND RECORD
Owner KELLY J/JOAN F QUINN
Create Date 02/22/2007
Contractor OWNER
Fuel ~ Gas UOil
. System o New
U Forced Air U Radiant
U Electric ~ Hot Water
Chimney Type D Chimney A D Chimney B
Heat Loss D As Approved . Existing
BTU Rate () As Per Plan C) Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam
U Suppl.
. Direct Vent
U Solar U Solid
o Other
U NC U Vent
U Con. Burner
() Not Applicable
() Not Applicable
. Other
Value
Value
84000
Use/Nature Replace boiler, recirc pump and install new expansion tank.
of Work
Fees:. Valuation
$2,900.00
Plan Approval
$0.00
Permit Fee Paid
$53.50
Issued By:
Date 02/22/2007
o Permit Voided I
Parcelld # 1213610000
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 se re any ne ssary approvals before starting such activity.
Signature
Date ~ - J{)-()7
Agent/Owner
Address
OSHKOSH
WI 54901 - 0
Telephone Number
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
t Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
ON THE WATER
HVAC PERMIT APPLICATION
All infonnation after bold categories must be provided.
Incomplete applications will not be processed.
· Application(s) and fee(s) can be br<;>ught to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128,
Oshkosh WI 54903-1128. Commencing work without pennit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If v.ou are a contractor Darticivatinf! in the Permit fee Account Svstem and have adequate funds. check here
if vou want thisprocessed through your account n . ""
DATE J - ;) ? - 6 ?
JOB ADDRESS " ) 1 j Q Co 1lJ. ~ J:>, '.
.OWNER;(eI!y'T Qu ,)v fV. I
CONTRACTOR S I1hJj 4$ MOVE
CHECK Ja ALL APPLICABLE
U~ CATEGORY
EfSingle Family DDuplex DMulti-Family
DRental
o Commercial
DIndustrial .
FUEL
aGas
DOi!
DElectric DSolid
o Solar
SYSTEM
DNew
DOther
DReplace
TYPE
DForced Air DRadiant DSteam DAlC DVent DElectric [dHot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINED DNo DYes - LINER SIZE
Note: All chinmeys shall be sized per the BTU's being vented.
& MANUFACTIJRER
CHIMNEY TYPE
HEAT LOSS
BTU RATE
DChimney A
DAs Approved
DAs Per Plan
dChimney B
rnExisting
DVariable
B15irect Vent
DNot Applicable
DOther Value
OOther
<6 l( 0-0 :)
J
B T\A
DESCRIPTION OF ALL WORK BEING DONE
rXfp~ lJfl~__ h,..-t(
~i? 19/A~k
7
fJll i)tfVL-- ~ Pl-J ["Iv >#//
VALUE
.$ 1,? t ()
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ELECTRICAL CONTRACTOR
o For applicable projects, an Electric Installation Verification form, sigued by the Electrical Contractor, must be
attached. If not attached or not applicab~e, a separate Electrical Permit is required.
9/02