HomeMy WebLinkAbout0123749-HVAC (boiler)
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OSHKOSH
ON THE WATER
Job Address 934 OTTER AVE
CITY OF OSHKOSH
No
123749
HVAC PERMIT -APPLICATION AND RECORD
Owner NANCY RAE MIRR
Create Date 03/09/2007
Contractor A-1 HEATING & AlC INC
Fuel ~ Gas UOil
System o New
~ Forced Air U Radiant
U Electric U Hot Water
Chimney Type U Chimney A C) Chimney B
Heat Loss KJ As Approved . Existing
BTU Rate U As Per Plan () Variable
Category 500 - Residential-Heating & Ventilating Plan
U Electric
o Replace
U Steam
U Suppl.
() Direct Vent
U Solar
U Solid
o Other
U Vent
U AlC
U Con. Burner
. Not Applicable
C) Not Applicable
. Other
Value
Value
80,000
Use/Nature SFR / Replace boiler. EIV provied by Bell Electric.
of Work
$3,700.00
Plan Approval
$0.00
Permit Fee Paid
$65.50
Date 03/09/2007
Fees: Valuation
Issued By:
~
o Permit Voided I
Parcel Id # 0203990000
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.
02!19J~007 MON 7:37 FAX 1 920 733 2713 WATTERS PLUMBING
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Electric .1nstalJation VeriflcatJon
I (We) _1itLb._,_J!...L,<,~1-r; c... ,
(Electrical Contractor Name)
...,i!..t!.:.._/& f} )!~M 1/ 2 .., /fItfll7~,}h~ "'/ , .) Y? S 2-
ddre3s) (Cily) (State) (Zip Code}
mHnClr.'X1 10 perform electric insl~lation work for A:-l tff!{1.rJ,"J (f .IV ,--,
a D3 - 0371 ~J - 130..5 (t"/( (Name ofpart)' contracted to}
931./ tJ1-Irr A(/e ~2(~ 1((>)1, I<t:-('I ~y m."rf'
(Address where work will ~ pcrfonned)
of the work consisls of: (Chc<:k One or Describe the Nature of Work)
RcconnCCllon or new circuit for rcplncement~ri~ ~dlor NC Condenscr.
Reconnection or new circuit for replacemellt El"trlc Wou<< Heater or power vented
water heater'. .
Rcconnection <;If the St:rvicc: Entrance Cable, Meter Box, alterations 10 receptacl09
ulld ~ighting fixtures due to ~ilting I ~offlt in..'ltl1llation, Note: New S~l"Vlcc
Entrance: Cables wj() require a s~rate pelmil.
Rcconnection or n~w circuit for the replacement of other permanently W1m!
applian~e31 fixtures,
New circuit for thtl addition Qr Ale to vn illdividUfl( dwelling tlnit (house or the
il\dlvidual3ystems in Q duplex oreondominium), includingrequirc:d service
dCClricI11 outlet\>.
Other
..-.....-~_... --..
-----......-...."'....
~ .,
Thl: v~h\e r Ihill work is $..
-'
I hcrchy \' rify this work will he performed by an employee of this company and further verify
(he reCQ111l 'ction I installation will be done in compliance with manufnctuler.lU1d Electric code
I'c(\tliremr ll;l.
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(~ig"lJtll c or Com~).\"y om<.:cr'
~~A [:' --?eN
__.._ Ct. (... -~~ <.A -'
(Prilll Name ofOfticer)
_./! -If' -'0'1
(Date)
~"')1
3697
T);,t ~
~'d
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City of Oshkosh
Division of Inspection Services
PO. Box) 130
Oshkosh, VVI 54903-) 130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications will not be processed.
ctJ
OfHKOfH
ON THF WATER
· 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 pennit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
I
in. the Permit
our account
check here
JOB ADDRESS 9' 3 'I Of te (' 11 ve OJ I; /fe,:> 11
OWNER f<t..;12y Ihfrr J6'3'-03}1
,
CONTRACTOR A-I JI-ee't1);':J do- fi 11\ t:(.I,'1 ~,d'~Jr17JJ 9.:)1,'- 77y - ffs3 r
DATE
,)-/16/07
f '
CHECK [tJ ALL APPLICABLE
OSECA TEGORY
~ingle Family. ODuplex
DMulti-Family
DRental
OCommercial
OIndustrial
FUEL
DlGas
DOil
OElectric OSolid
OSolar
SYSTEM
ONew
OOther
.eplace
. TYPE
)fForced Air ORadiant DSteam ONC OVent OElectric DHat Water OSupp1.0Con. Burner
IS CHIMNEY BEING LINED ~No DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CffiMNEY TYPE
HEA T LOSS
BTU RATE
OChimney A
OAs Ap.nr.oyed
OAs Per Pian
OChirnney B
~xisting
OVariable
ODirect Vent O1Other ;1,/(,
DNat Applicable
,-OOOther Value iV; Ud D
I!l ~/t ,/wAz((r>Y:,vvx(J-
-
DESCRIPTION OF ALL WORK BEING DONE
V A Ltilhl ~d~d ;ng labor and aU ma terl als I neludlng Ught fixtures) $ 3" J PO' r , f' If J . J"" a-. ~ Ij ~ I/)
ELECTRICAL CONTRACTOR Bt? /' ( OR 0 Electric Installation Verification form aftached(lf Rep,acLent)
Elec/rical instal/a/ion of new/replncemenr equipment shall be done by licensed COIl/melon
IF"] /J9 7
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