HomeMy WebLinkAbout0123753-HVAC (furnace)
e
OSHKOSH
ON THE WATER
Job Address 1243 WESTERN ST
CITY OF OSHKOSH
No
123753
HVAC PERMIT -APPLICATION AND RECORD
Owner TODD J HEALEY/ERIN R DUNHAM
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 [) Chimney A () Chimney B
Heat Loss () As Approved . Existing
BTU Rate KJ As Per Plan o Variable
Category 500 - Residential-Heating & Ventilating Plan
U Solar U Solid
o Other
U AlC U Vent
'.' U Con. Burner
. Not Applicable
U Electric
o Replace
U Steam
U Suppl.
() Direct Vent
o Not Applicable
. Other
Value
Value
Use/Nature SFR / Replace furnace. EIV provided by Bell Electric.
of Work
$2,400.00
Plan Approval
$0.00
Permit Fee Paid
Fees: Valuation
$46.00
Issued By:
~
Date 03/09/2007
o Permit Voided I
Parcelld # 1203410000
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 at236-5128 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.
-'021 19/2007 MON 7: 37 FAX 1 920 733 2713 WATTERS PLmlBING
~OO2l005
~'''yor~~k\l~'
[II."..... orll\'l"'<lk1n /i('r--k,.
ll! ('bu~1I A_
l'<lllo... IlJO
OWl~'"'' Wf "V(1~ .tHO
(,lrr0C6 \l2\l.l~'O)\l
f.. 'lll- "1). $()~'
Electric tnstallntlon Verification
l (We) ~..__p..L~G-i"i c...
(Electrical Contractor Name)
.--'p:'q.:..._.~' II ~ ."_ /Jl~I1~.lh~ "'-<' t .)Y75:2.
ddress) (City) (Slato) (Zip Code)
nllvc bee" C\ll\lrilcted to perform electric )(lS(DUllliol1 work for I)-I tI!;.~.!f";'J- ff AI G
'1/0- ;1.1./30 (Name of party contracted to)
l~yL..VIt65ti''''n 5..t QS4J(4 s ~ Eft;! tJl/HItc,,"1
(Adchs5 where work will be performed)
,Check One or Dcscribe the Nature of Work)
ReconnC(:\ion or new circuit for replacement eating P t and/or Ale Condtmllel'.
RCCOMectlon 0" new circuit for replacement c Wator Healer Of power vented
wate( hctUer.
Reconnection oJ' the Service Ennance Cable. Metor Box., nttemtlons to receptaclo!!
and lighting fixtures due to Riding I soffit installation. Note: New Service
Entrance Cables will require n sepnratc permit.
Rcconnc:ction or n~ circuit for the replaccment of other pennanently wired
appliances / fixtures.
New circuit for the ~ddition of Ale lO Dn individual dwelling un(t (house or the
individual systems in L1 duplex or condominium), including required ser\llc~
clcclriClll outlets.
01her
.._--'.............~-----
7'1" '':
The \I\lllIC Or \hi~ w~rk is $,..
-'
\ berchy vcri fy this work will he perfonned by an employee of this company and fur1bcI verify
Ihl: recol1l celio" f installation will 00 done in compliance with manufacturer and Electric code
rcqulrCIlH "1:<.
~_: /d!tf2____
(Sil~nall n: o,'C'omp\\IlY Officer)
.d'.'."."""
,;,.r"
(
...~".
(((<,.. /C:Z;~N
---. ....... -
(Prilll NQ01C of Officer)
__2 -./9., 0 '1
(Date)
37/'(
~/()2
~b ~
7.'d
t;nR!'lR/.I.n?F>l I TlHJn:1 >'lTH rTlJH fHJT II-J'::lH IH
\.l~~i: I I,no? 1.1 q~4
,..,
City of Oshkosh
Division of Inspection Services
P,O, Box 1130
Oshkosh, VVI 54903-1 130
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.
~
OfHKOfH
ON THE WATER
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box I] 28,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
/ au are a contractor artici atin in' the Permit ee Account S stem and have ade uate unds check here
if you want this orocessed through ;ou/. accoun!-D
DATE ). //JID7
I /
JOB ADDRESS j:J.. 7''3 \,j~Sf+'rN S r O,~fj;(v& 4
OWNER s'rlJ../ fJUH )14111 jf/~J - ~ Lf 30
CONTRACTOR A-I JI-ee:.1);';j d-fil~ C(}"I~,J'~JIlhq X:).iJ-7.7y-},..'r/3f
v
CHECK 6?J ALL APPLICABLE
USE CATEGORY
.P?J.Single Family' DDuplex
DMulti-Family
DRental
DCommercial
Dlndustrial
FUEL
)~lGas
OOil
DElectric OSolid
DSolar
SYSTEM
ONew
DOther
rMReplace
TYPE
,0:'Forced Air ORadiant OSteam ONC OVent OElectric DRot Water OSuppl.OCon. Burner
IS CHIMNEY BEING LINED)tlNo DYes R LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
& MANUFACTURER
CIDMNEY TYPE
REA T LOSS
BTU RATE
DChimney A
OAs Ap.nr.oyed
OA.g Per Pfan
OChimney B
PExisting
OVariable
DDirect V ent ~ther A/C
DNat Applicable
pother Value ,,(.~ cl(:) D
DESCRIPTION OF ALL WORK BEING DONE
F~;..,i.'v,tl ./"w~a~'f)''1'1rxr-
- t
IP
I' Ult.nJI1~1
V ALUE (Including labor and all materials including light fixtures) $ ~r 'I,-,7('''''? T. r
ELECTRICAL CONTRACTOR lJe ( L- OR 0 Electric Installation Verification form attached(lfRePlatmentJ
Ei:'ctrical instal/tlIion oj newlreplncement eqllipment shall be done by licensed con/melOn
CJob ;:I. <_1 7 I 7'