HomeMy WebLinkAbout0123723-HVAC (boiler)
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OSHKOSH
ON THE WATER
Job Address 1101 CEAPE AVE
CITY OF OSHKOSH
No
123723
HVAC PERMIT -APPLICATION AND RECORD
Owner MARK A1THERESE M BURAZIN
Create Date 03/07/2007
Contractor A & G ANDERSON HEATING & COOLlN(
Fuel ~ Gas UOil
System D New
U Forced Air l!:J Radiant
U Electric U Hot Water
Chimney Type () Chimney A () Chimney B
Heat Loss KJ As Approved C) Existing
BTU Rate KJ As Per Plan C) Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam I
USuppl. I
U Solar U Solid
D Other
U AlC U Vent
U Corl. Burner
() Direct Vent
. Not Applicable
. Not Applicable
. Other
Value
Value
Use/Nature SFR/ Installing a replacement boiler.
of Work
Fees: Valuation $3,450.00
Issued By: UlAr-
Plan Approval
$0.00
Permit Fee Paid
$62.50
Date 03/07/2007
D Permit Voided I
Parcel Id # 0805060000
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
162010WAST
Oshkosh
WI 54902-0
Telephone Number 651-6695
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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.
c..e
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
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OJHKOfH
'ON THE 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 doub~ed or $100.00 plus the
normal permit fee, which ever is greater.
OR
ffv'ou are a contractor particivatinf! in the Permit fee Account System and have adequate funds. check here
if yOU want this processed throuf{h your account n '
DATE J - ?- '-0 t-
JOB ADDRESS I! 6 I C-e....rO~
,
, OWNER rM e.-.r Ii. 'f T-G-,-..., '"'-
'CONTRACTOR _~ J ......... <.c-- 14-~T~-I C "'A..w.-?
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CHECK fa ALL APPLICABLE
USE CATEGORY
9tSing1e Family DDuplex DMulti-Family
DRental
o Commercial
DIndustrial .
FUEL
1idGas
DOil
DElectric DSolid
DSolar
SYSTEM
DNew
o Other
DReplace
TYPE
DForcedAir &m.adiant DSteam DAlC DVent DElectric OHotWater DSuppl. DCon. Burner
IS CHIMNEY BEING LINED ~o DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTIJRER
cIiIMNEY TYPE
HEAT LOSS
BTU RATE
DChimney A
DAs Approved
DAs Per Plan
OChimney B
~xisting
DVariable
DDirect Vent DOther
DNot Applicable
DOther Value
I>ESCRIPTIONOF ALL WORK BEING DONE ~u__--<- -1:-;'-'-'3 ~ IJo.-t.--... ~:t:.~
J,-, ~ lA/ hl"""/~
VALUE
.$ -:iJ L/ SO o..e/
....
ELECTRICAL CONTRACTOR
o For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicab~e, a separate Electrical Permit is required.
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