HomeMy WebLinkAbout0124496-HVAC (a/c)
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OSHKOSH
ON THE WATER
Job Address 1512 JACKSON ST
CITY OF OSHKOSH
No
124496
HVAC PERMIT - APPLICATION AND RECORD
Owner KIMBERLY L SZOZDA
Create Date 04/30/2007
Contractor MARTENS HEATING & COOLING
Fuel U Gas UOil
System ~ New
U Forced Air U Radiant
U Electric U Hot Water
Chimney Type U Chimney A C) Chimney B
Heat Loss o As Approved C) Existing
BTU Rate KJ As Per Plan C) Variable
Category 501 - Residential-Air Conditioning
Plan
U Solar
U Solid
o Other
U Vent
U Electric
o Replace
U Steam
U Suppl.
() Direct Vent
U AlC I
U Con. Burner I
. Not Applicable
. Not Applicable
. Other
Value
Value
Use/Nature SFR / Install central air. EIV provided by D Kal Electric.
of Work
Fees: Valuation
$2,177.00
~
Plan Approval
$0.00
Permit Fee Paid
$43.00
Issued By:
Date 04/30/2007
o Permit Voided I
Parcelld # 1501750000
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
PO BOX 514
aMRa
WI 54963 - 0
Telephone Number 920-686-0111
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
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
HVAC PERMIT APPLICATlON
All information after bold categories must be provided.
Incomplete applications will not be processed.
~
OJHKOJH
ON THE 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 $100.00 plus the
normal penuit fee, which ever is greater.
OR
If yOU are a contractor participating in the Permit fee Account System and have adequate funds. check here.
if yOU want this process~d th1"ough your account n
,JOB ADDRESS / .s- I ~J 4 c K.n) ~--, s j-.
OWNER K' ,1 ..-1 S Z. 0 -z:.. j C-\
CONTRACTOR fJ10\'[+€~'5 l4t=-ct1.'.-1, d CCJj.~...,
I
DATE Y. ';;7, 0 '7
, .f
CHECK 6ZI' ALL APPLICABLE
US~CATEGORY
rn3ingle Family DDuplex OMulti-Family
DRental
o Commercial
o Industrial
FUEL
DGas
DOn
DElectric OSoIid
o Solar
SYSTEM
f:1l\k~ -Lf.' .... OReplace
OOther . ~
TYPE
DForced Air ORadiant DSteam DAle DVent DEIectric DRot Water OSuppLDCon. Burner
IS CHIMNEY BElNG LINEDDNo DYes - LINER SIZE
Note: AU chimneys shall be sized per the BTIJ's beingvellted.
& MANUFACTURER
CIDMNEY TYPE
BEAT LOSS
BTIJ RATE
DChimney A
DAs Approved
DAs Per Plan
OChimney B
OExisting
DVariabIe
DDirect Vent DOther
DNot Applicable
DOther Value
DESCRIPTION OF ALL WORK BEING DONE .~ <> t." t. (
(: (,\ w.ct r-_-. I ./1 " r
VAL DE (Including labor and aU materials including light fixtures) .$. 2 I '77. 0 ~
~ rf~U
\1
ELECTRICAL CONTRACTOR ,(') t: A- L
OR 0 Electric Installation Verificlltion form attached(lfReplacement)
Electrical installation ofnew/replacemem equipment .~hall be done by licensed contractors
3/02
Cil'/ of Osbi>ool>
Oi'ii9ilJtltl ....flll"P'e!;ln;(}!. g,.",j"",
:H5 Cb..""hA""iIlu",
PO&lIl130
Osllkoill1 WI ;$4!JJ02-1 no
om"" 9;?O,2:3ti-.5{j!/{)
1'l1Ix 920- 23(i.~Ofl4
~"'::rHKCllF~
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ON 7HIi WATE~
Electric :~Dstalla.tio.B Vedfieati&D
0) (W'e) ___ Q_.L_JSEl_____._~J. c9...~'f- r: ~~____..-____._.._____.._________
(E~ectri.iC.lli.R C())'[ltlr~etoK Name)
_-7...~Q.2.---~-(S-_~.s.:-~f~..~.L-./t~~~=---.--.-Q..~C.-~.-~~ ~_~r..?_~J:...
(Ad.dress) {City) (State) (Zip Code)
have been contracted to perfofilOl electric instaU:;JlJeioJn ,\)IJOtt. :fl()]~ .-_J:~L~-_~_~_& z. ~j "" ______.__.,
(N:lllme of party c.onll:racted to)
at the following .address;__.L~_-I_~_____.._.:J'~_~1: .1l=? --'____ ~ I_.._________-______.
(Address '~lVhIi1Jl]::: work wHI he :perfomu~d)
Th~ nature ofth.e work cm'l$i'1;ts of: (Check One or Describe the Nailwe of Work)
/' Recoooectiton or luew dllrcuiit for rep,laceul.el1t llea,tullg Plant and/or Ale Condenser.
-- ReconDec1tion or new' circuit. for replacenaent Electric Wate.r Heater.
ReC<<'}W,lflct.ion of the Service Entrance Cable, M.eter Box. :alterations to receptacles and
HgbtiUt.g fixtiIlJfe5 due to siding I soffit insta111atioD. Note: New Service Entrance
Cables "olViU require a s(;~pf:ir21.tif,; pemmit
Rej~oll1i1<<,_,tJion or new circuit for .other per.ill.lZine:rad:v' wired Rpp1i~ces I :fixtures.
Other
-"~--.-.-~,...."---"--_.-.,....--~----.-._._..._,...~:-:..~..,,_._~-..,......,.~..,-:--'-_..~....~_._...,.,....-,.......':"I"'....,.,..,.,........--"-....,.........--_.--~---~.,._"~-..._.-.~
The value of this work is $__.1__..:rq,:._..-Q~_..
I hereby verifY this work win be p-erfornlled by au employee of this company and further verify the
reconnection I insUln~tion win be done in compliance with mamlufaciurer and Electric code
requirements.
~ '.~ - ';.'.: ",~,...~.."';""_.'",....~
CJ~ :J- ~
~d......,,-_._._..._~_--,~- . ~
(Signlllture ofComp~ny Officer)
.~~~.LhK~/q~__,.__
(Print Name of Officer)
--------~_._~-~._.-
(Dale)