HomeMy WebLinkAbout2007-HVAC (furnace & a/c)
e
OSHKOSH
ON THE WATER
Job Adldress 1078 W 4TH AVE
CITY OF OSHKOSH
No
124822
HV AC PERMIT - APPLICATION AND RECORD
Owner JOHN AlEDITH A NIEMAN
Create Date 05/16/2007
Category 502 - Residential-Both
I Electric
o Replace
U Steam
I I Suppl.
. Direct Vent
Plan
Contractor THOMPSON HEATING AND COOLING S
Fuel ~ Gas IJ Oil
System n New
~ Forced Air U Radiant
U Electric I J Hot Water
Chiml1ley Type D Chimney A () Chimney B
Heat L.oss . As Approved () Existing.
BTU Rate D As Per Plan ( ) Variable
U Solar
I Solid
I
I
~
~ AlC J
I J Con. Burner I
() Not Applicable
() Not Applicable
. Other
Use/Nature SFR / REPLACE FURNACE AND ADD AlC, EIV SIGNED BY T RUCK ELECTRIC
of Work
Value
Value
Issued By:
~
Plan Approval
$0.00
Permit Fee Paid
$76.00
Date 05/16/2007
Fees: Valuation
o Permit Voided I
Parcelld # 0607610000
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 per . appli ation within an easeme t, the City strongly urges the permit applicant to contact the easement
holder(s) and to f 'i ecessary a rovals starting such activity.
Signature
Date
$~~7
Address
901 OTTER
OSHKOSH
WI 54901 - 0
Telephone Number 920-426-3095
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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.
~
~'--.'
/'
~
OlFF07R
ON 'Mr wA'I1i~
City ofO~hk~h
Divltk>" or i!ISpWtionSe1vices
215 ell_I! A "e"tot '
l'O 90x 1 1)0
OsbJcosh WI SII902. 11 JO
Offiec 'J2(\.2JM05t)
fllJ\ nO-23~SO"
...
Electric Installation Verification
,-,... .. -......,...:.,. ....'. '-. -.,..,;....,..... '- ,- ....
...:,.'t
'~-' ,.
,w~.') \' .-- '\" ~/
(I) ( e) .-:-~c~..'-.". ~. ~. ___~4~-L. c.... ....r-~U}~--~--"-'--
.. . (E ectrkal Contractor Name) 7'-
;","'?",:;~-:::.T}i:,;:\,,:r~
i.1~ssP' ~~7Z~fn' - ->>i:ft;r~. fzr~~t
~'~::'::i., ,,0 ',' ,- .<>:'~::~':'
have beeri4hrra:~loper[9rIT) el.eclric illslallatio~ wo,~ for ~~-,
'. '... 'i . '. (Name of party <:~ontracted to)
at the fQl1Qwing address: --J,()~7..1~~ ..:.-_'-ltb-------..-----~---.--:--------~-.
(Address where work will be perfonned)
The nature ofthe work consistsof: (Check One or Describe the Nature of Work)
L;econnection oTnewdrcuit f<?rreplacementHeating plant and/or Aft Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection ofthe Service EntranceCable, Meter Box, alterations to receptilclesano
lighting fixt\1res due to siding I soffit installation. Note: New Service Entrance:.
Cables will require a separate permit.
Reconnection or new circuit for other permal1ently wired appliances / fixtures.
Other
,~y~Jf.~':I...".",::{~'I;,- ;" <i:.<{ ."'" 't:",'.*!,. .' .1"!!'~P' ':.\, 11.\10." ~
-----_.~--~--_._._..~-_._.._-;--"'--:--'----_._~--:-..'--
..------------
--_..._-...,..-~-.._---------~
.......-...._-.------._----~~
The value of Lhiswqrk is$~-~...--------.
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection I insla,H.~H<?r' ~ill~e: g()I'lC:. ill.,9()mp liance with manufac~r,e:ranc:lE le:ctri~ ~{)de
reqllifements. .
4~~o~~F
~;t-~4~-CY1
City of Oshkosh
Division ofInspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
(f)
OfHKOfH
ON THE WATER
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 be~g doub~ed or $100.00 plus the
normal permit fee, which ever is greater.
OR
lfy'ou are a contractor Darticipatinf! in the Permit fee Account System and have adequate funds. check here
if yOU want this processed through your account n .
DATE
$//'-,/b 7
,
JOBADDRESS /t2?8' {P, ~
'OWNER ~.d.~ AJ/6"1MA;:.J
'CONTRACTOR /l.-k)/tt/lp, (()~ f~'74-j-?jJ~
, ' I .
CHECK Ia ALL APPLICABLE
USE CATEGORY
d1Single Family DDuplex DMulti-Family
7"..
DRental
DCommercial
DIndustrial .
FUEL
~as
o Oil
DElectric DSolid
o Solar
SYSTEM
DNew
o Other
~Replace
TYPE M", I C
)l(ForcedAir DRadiant DSteam ~ DVent DElectric DHotWater DSuppl. DCon. Burner
IS CHIMNEY BEING LINED DNa t(Yes - LINER SIZE S" & MANUFACTURER
Note: All chinmeys shall be sized per the BTU's being vented.
CIDMNEY TYPE DChirnney A t1Chirnney B !XfDirect Vent DOther
HEAT LOSS Q{As Approved DExisting DNot Applicable
BTU RATE DAs Per Plan o Variable , ~Other Value 2Z!JT1l ~
DESCRIPTION OF ALL WORK BEING DONE t't-f> ~- k~l-/~ M.~ 14 Ie
/
VALUE
.$ 4cI!7J. lD
ELECTRICAL CONTRACTOR G/ t/
o For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicab~e, a separate Electrical Permit is required.
9/02