HomeMy WebLinkAbout0124630-HVAC (furnace)
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OSHKOSH
ON THE WATER
Job Address 158 N LARK ST
CITY OF OSHKOSH
No
124630
HVAC PERMIT -APPLICATION AND RECORD
Owner DOROTHY L GERNER
Create Date 05/04/2007
Contractor RYF 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 () As Approved () Existing
BTU Rate () As Per Plan . Variable
Category 502 - Residential-Both
U Electric
~ Replace
U Steam
U SuppL
. Direct Vent
Plan
U Solar U Solid
o Other
~ AlC U Vent
U Con. Burner
C) Not Applicable
. Not Applicable
() Other
Value
Value
Use/Nature ~FR / Replace furnace & AlC. EIV provided by Seckar Electric.
of Work
Fees: Valuation
$6,000.00
~
Plan Approval
$0.00
Permit Fee Paid
$100.00
Issued By:
Date 05/04/2007
o Permit Voided I
Parcelld # 0608850000
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 450
WINNECONNE
WI 54986 - 450 Telephone Number 920-582-4451
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 ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fa.\": (920) 236-5084
~
OfHKOfH
ON THE \VATFR
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 doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
J(vou are a contractor particivatinJl in the Permit lee Account System and have adequate funds, check here
if you want this processed throu'lh your account n
DATE S- -;2.. - () 7
JOB ADDRESS /5"f!3 N /..~A.. 5, t:
OWNER Dc d-t, " G", ,.. ~-e""
CONTRACTOR Ii?- P. If'c:4--i-V :) ."... tfi,-G 0 r:: Iv' G
CHECK la ALL APPLICABLE
USE CATEGORY
,giSingle Family DDuplex o Multi-Family
o Rental
o Commercial
DIndustrial
FUEL
~as
DOil
DElectric DSolid
DSolar
SYSTEM
DNew
DOther
)qReplace
TYPE
~Forced Air DRadiant DSteam)&lNC o Vent o Electric DHot Water DSuppl. DCon. Burner
IS CHIMNEY BEING LINE~o DYes - LINER SIZE
Note: All chimneys shall be size~eMe BIU's being vented.
& MANpF ACTURER
CHIMNEY TYPE DChimney A DChimney B ODirect Vent BOther
HEA T LOSS DAs Approved o Existing ~ot Applicable
BTU RATE OAs Per Plan .)!SlVariable DOther Value
DESCRIPTION OF ALL WORK BEING DONE I?~LJ luc---c.... fit/'/J&LL e- ;- f'1=.-c..
I
RECEIVED
VALUE (Including labor and materials) $ t. 0 e> ;:>, 0 C>
MAY 4 2007
Ie. DEPARTMENT OF
ELECTRICAL CONTRACTOR ..)~t::- A. r COMMUNITY DEVELOPMENT
U For applicable projects, an Electric Installation Verification form, signe~~ifI~~8MI~b.~JQN.st be
attached. Ifnot attached or not applicable, a separate Electrical Permit is required.
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Electric 1..taUat1oa VerUleatioD
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(IlICtriO&l eon_tor Name)
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(Acldreu) (Qty) (Stat.) (Zip Code) S 4 7 t b
.". "'" ooatt'" $0 PtrfoI:B1 .1Iom" inltalla1iQn work tor f2 y.p H €.f'rT/ tV ~
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11.. .uo.... addnM: /5R AI j.,4"# It.- S 1-;
(A4=-u wheN work will bt perfozmect) -
Tbt ....01.... wo&oauiItf or. (ChIck OM or DeIai'bll the Nature of Work)
Xl ___..1Ita or uw cirouit for rtp)....-.t Meatiq Plat lCidIor AiC ConcIIuer,
C ...,.... or.., otrcuit tor rtp*1ZUDt IlflC1rio Watt: Hllter or power vez2t.d
wtIIr... .
_ .. GU.,1ite ottb. 8vviot Saauoano. Cable. MetIr hx, a1ttrIeicml to ~~1.
... UaJItin. ftxtuNI t:N. to lidiq IlOflt ilUtlUadon. Note: Ntw S4trYice
.... Clbla wi11 Nqw. .....ateperadt
_ J.coat..... craN circuit tor tJw l'l'Jactmll1t otothel' PerJUllll1t1y wired
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N_ .... fbrtbl addition ol41C to an '.'w_l....,.l1~ llIfil (hoUM or lb.
mdlvtclu&l .yattm.s in I dupllx or cocdomittlum). illcludin, reqt1iMd $avice
1IIt1dIIl odttl.
_ Other
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The valut,otUU. wode iI S to 0 .O~
11wI1t)' v..ilf tIdI wortc will be pcwfoaed by an =pl0)," 1)fthJs company and t\u-.hcr \i.rity
tM '**'~\tOd.1 {..nation 'WiU b, dozw in compUlI1ct with ma=u.~'urer L'1d !lectric code
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(S~Otllcer)
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(Print NUDe of OMcw) (D..)
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