HomeMy WebLinkAbout0124650-HVAC (furnace & a/c)
o
OSHKOSH
ON THE WATER
Job Address 949 OSBORN AVE
CITY OF OSHKOSH
No
124650
HV AC PERMIT - APPLICATION AND RECORD
Owner LLOYD K LARSON
Create Date 05/07/2007
Contractor
MARTENS HEATING & COOLING
Category 502 - Residential-Both
I Electric
~ Replace
U Steam
U Suppl.
. Direct Vent
Plan
System
L~I Gas
o New
~ Forced Air
U Electric
Chimney Type 0 Chimney A
UOil ~
U Solar U Solid
o Other
~ AlC U Vent
U Con. Burner
Fuel
Heat Loss
[) As Approved
o As Per Plan
U Radiant
L j Hot Water
() Chimney B
. Existing
. Variable
() Not Applicable
BTU Rate
C) Not Applicable
C) Other
Value
Value
Use/Nature FR / REPLACE FURANCE AND AlC, EIV SIGNED BY D.KAL ELECTRIC
of Work '
Fees: Valuation $6,924.00
Issued By: fun LJ
Plan Approval
$0.00
Permit Fee Paid
$115.00
Date 05/07/2007
o Permit Voided I
Parcelld # 1310200000
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
OMRO
WI 54963 - 0
Telephone Number 920-685-0111
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.
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pO \'!lOx 030
OSl\\>QSb 'lifl 54902.1130
ot\l,;<; 9Z0.Z3€.-S050
fM 92o.-'-:36.5C\Vi
7 2007
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
Electric llllltllnll~ VerificlltiMl
RECEIVED
MAY
O (<- r 6~ _L~
. . ~ "" -, r. c.... ..-----...--
(l)(We)--~..~--~
(Electnci1 Connacto1 Name)
W t-IO -z. R vsk~"r/J_~~Q~~~9~
_._-j.~-_.~-.-_~---~--"--'--"-"--""- fe-hI) (State' (Zip Code)
(Address) ,......,J'
_ L' .u0-. i ADC/'IrJ
have b_ conifJlCl"d to perlo"" electric inst,ulmon work for --~~"
" (N_e of partY .",..nacted to)
o -0 () ( _ A,
.tthe lbUoWing ed<Jr<'!S' _Li.1--...'i.nt:.U:-D-:c-J.DLfI----------.
(Address where work. ,ml! be 'Performed)
Tho """"" oftbO """" consists of: (Cbe<.k One or D=riho the N- of Work)
:vt R~"" or ""'" circuit for rop_ent Healing P\s<ll and/or AlC Coo<J<:nSer;
R""""""'tion or new' circuit for repl"""",eot Etectri<: worer Heater.
~ of the Service En!r8lJC'l Cable, Meter Box, ~ to receptacles and
lighting fixtmeS due to siding I soffit inSlaIlolioo. Note: Now Service EntnmCO
Cables win Jrf.'quire ~- separate; permit
R~ or new cirouit for other ~\y wired appliances I fixture..
Other
..--.--.-.......-.--.----.---.--..--.--...------...----------_._._-_..------~---~-~.._-_.._---_..
----..-...--...----....------ ------------...---------.------------- ---------
-_.._._.__..._------_.__._..__._--_...._._...._....._.._-_._._--~-----........,.....---------_...._--------~
The value of tlriswork is $ I SL;.. n (')
_....~..._._.........-_._-"._-------~,"
I hereby verify this work wm h'" T''''''''''''m''' d 1\...
. . '. . .." ~_",v ..0 UY lID employee ofth' .
reconnocl1OnI tnstallation will be done in romplionce w'th ': COUlplUly aod furthet verify the
req,,""'''''''ts. .' .. manu..acturer and Electric rode
~s~:~
\\.' HEl.1\.lil1ture ......f en 0 ~.
:,;r, '" . u,. A...mpany .. fficelr)
._D,,;c UJ:;:~q5
(Print Name of O&ii:: -) .
u.<<ceT
5--20'-
I (Date) .~ I
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, VVI54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
RE~~~~ED ~
DEPARTMENT OF OJHKOJH
COMMUNITY DEVELOPMENT ON THE WAiER
HVAC P'ERM1T A~1tiIONES DIVISION
All infQnnation after bold categories must be provided.
Incomplete applications wilInot 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
Ifvou are a contractor participating in the Permit fee Account System and have adequate funds. check here
if vou want this processed through your account n
.JOB ADDRESS cr r 7
L / "
OWNER I rJ [I ~",A L.... C\ I~ .5"ch,
CONTRACTOR rde{(r-t'6'k;J /;IG-"'e:t:f ) e'[",
"
Osba fV"\ A've:
DATE .$"
,
<-,07
.'
J
(~..:, {/'l-'t'j...
CHECK &?l ALL APPI~ICABLE
USE.eATEGORY
p"
rnsingle Family ODuplex OMulti-Farnily
ORentaI
OCommerciaI
o Industrial
FUEL
,,'
".../
OOas
DOil
DElectric DSolid
DSolar
SYSTEM
DNew
DOther
,~
El'Replace
TXPE J. .
~orced Air ORadiant OSteam rptVC OVent DElectric DHot Water DSuppl.DCon. Burner
IS CnmV BEING LINED.~ ClYes - LINER SIZE___ & MANUFACTURER
Note: All chimneys shall be sized per the BTIJ's bej,ng vented.
CHIMNEY TYPE
HEAT LOSS
BTU RATE
OChimney A
DAs Approved
DAs Per Plan
DCllimney B gr5i;~ct Vent
~xistjng DNot Applicable
,r
GKT ariable OOther Value
R 6 pL~Cff
DOther
DESCRIP. TION .0. F.. ALL WOif'.' '. BE.. ING DONE
,....... f
I~'u r ~-"l .... ce j-' .,". '-.....
I/V A c.
VALUE (Ineluding labor and all materials including light fixtures) $ 6 9' J.. '/. eJD
ELECTRICAL CONTRACTOR D . lee, I OR 0 Electric Installation Verificatl:onform attached(lfReplacement)
Electrical installation of new/replacemem equiplnent slutll be done by licensed contractors
3/02