HomeMy WebLinkAbout0124896-HVAC (a/c)
cD
OSHKOSH
ON THE WATER
Job Address 1324 W BENT AVE
CITY OF OSHKOSH
No
124896
HVAC PERMIT -APPLICATION AND RECORD
Owner CARRIE W RAETH
Create Date 05/21/2007
Contractor MARTENS HEATING & COOLING
Fuel I J Gas UOil
System o New
U Forced Air U Radiant
U Electric UHot Water
Chimney Type D Chimney A () Chimney B
Heat Loss K:) As Approved . Existing
BTU Rate KJ As Per Plan () Variable
Category 501 - Residential-Air Conditioning Plan
I J Solar
I"'J Electric
o Replace
U Steam
U Suppl.
() Direct Vent
U Solid
D Other
U Vent
~ AlC
U Con. Burner 'I
. Not Applicable
() Not Applicable
. Other
Value
Value
Use/Nature SFR /Install newalc unit. EIV provided by D Kal Electric.
of Work
Fees: Valuation
$2,364.00
~/O
Plan Approval
$0.00
Permit Fee Paid
$46.00
Issued By:
Date OS/21/2007
D Permit Voided I
Parcelld # 1201960000
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 -514 Telephone Number 920-685-0111
1'0 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
Fax (920) 236;5084
(f)
O~lj~QlH
HVAC P'ERM1T APPLICAT,tON
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
I ou are a contractor artici atin in the Permit ee Account S stem and have adeu ck here
if vou want this processr;.g through your account 0
DATE
s-
, r
I 7 , 07
,
JOB ADDRESS I 3;l y U-J ~ e"Lf
OWNER C. 0.. If""} 6 R a. c;; 't-t,
CONTRACTOR fY7ct,-:tevt,s ~4ed-i),",,-,,\
A--ue;
, ( l
J. C c::ru . 't \I
"
CHECK 6ZT ALL APPLICABLE
USE CATEGORY
SSingle Family ODuplex OMulti-Family
o Rental
OCommercial
o Industrial
FUEL
o Gas
DOi!
~lectric OSolid
o Solar
SYSTEM
~ew
OOther
OReplace
TYPE
DForced Air ORadiantOSteam j)7A1C OVent OElectricDHot Water DSuppl.DCon. Burner
IS CHIMNEY BEING LINED :ONo OVes - LINER SIZE
Note: All chimneys shall be sized per the BTU's beingvel1ted.
& MANUFACTURER
cmMNEY TYPE
HEAT LOSS
BTU RATE
DChironey A
OAs Approved
DAs Per Plan
DChimney B
[]Existing
DVariable
DDirect Vent DOther
DNot Applicable
OOther Value
DESCRIPTION OF ALL WORK BEING DONE . H V A-~ - d T C) W
E[
MAY 2 1 2007
') 3 / DEPARTMENT OF
VALUE (Including labGr and aU materials including light fixtures) $ 0'- D Cj', 01::> COMMUNITY DEVELOPMENT
D ~'... I INSPECTION SERVICES DIVISION
ELECTRICAL CONTRACTOR _ v-. g OR 0 Electric Installation VerifiCation form attached(lfReplacemellt)
Electrical installation of new/replacement equipment shall be done by licensed COl1lracto/'s
<1C\'-I
\ 'J-~
3/02
(;;ly of O~hk...~l>
IDi-lisioo ('OIl"l"'"Rim. 5'''''1''''';
215 Cbtil>:1l A"""''';
IF'Oi'l<>" 1130
Osllllf.lllll WI 54902,1130
Offi<llli 92-0,236--5050
'fWt 920,236.;!i0f14
Electric :lnstaUati,o.ll Veri:fiea,ti..
(1) (We) __Q_.~_~L---.._.~l_~~~'f-;:~~~_.
(Electrical CO'lltraetor Name)
__'71Q~3-~~~_?~ ~3..!:.L..A_":!-:.~_......J;::?_~.~.i? ~_~.~._~~9 i:f.
(Address) (Cit.y) (State) (Zip Code)
have been contracted to perfmu1 ele,~~ric itn.8taRbtion wor.k. fox _(_~cr~ Rae t ~ ------..,
(Name of party contracted to)
at the folkil'\ll1ing addres..~: ___1_~_~_Y...-..__..~ _.___ ~ e VLt_.!l. ()f) -.-----~-----.-
(Address ')I.rhe:re work wm be perform.ed)
The nanu"(~ of the V\rock CAl11sists of: (Check One or Describe the NaiWite of Work)
,/ RecoDnection or nt.~W drcuit for repiaceK1D\enit Heati:n:Ji.g Plant and/oI' Ale Condenser.
..--- R,ecoonecti.on or ~~ circuit for replacen::l.ent Ele-.c1n:c Water Heater,
RCCOlIlllelct.ion of the Skmrnce Entrance Cable, M.c1.:er Box, alteran-o.D:S to receptacles and
ligh.til.'.n.g fixtures du.e to Biding I soffit installation, Not.e: New Service Entrance
Cables \!11m require 21. s/;;parate penn.it..
Recol1nection or new circuit fOT other permanently wired applian.ces / fixtures,
()1ther
~,.,.--,____._."__..__...__.~_~_...,__~'_N_'--"'_.-"--_,_,_~~",____,___"""""_""_,.""~_,,,,,,,__~,"'''''''''M'''''''__'--'-'-'-___~__-----r"____--...--~______
--_..._._._--_._-_....--..--,...-.._._.-...~---".-..---_..........--..-~..._-~~_.._------....,.,....-----~_._---------
_.-.....~-~------_._....__.._."-,..._.....--_._.,..........--..............-.......,-~--'....-_._.-----.-..,.....--,.-.,....---...,-....~..,...,......._.........-.-.,-~----".----...
The value ofthis work is $._~l~..:'"__9-<2__--..
I hereby velify this work win he perforrn.ed by an cUlployee of this company and further verify the
recOll.TIlei.~~ion I in$taUatio1\l w'iU be dooe in com.pliance 'jvith manufacturer and Electric code
requirem.ents.
~:f~~.
(Slgna1tUH.. of (,ompany Officel)
..~rAJ1~.L!:-.:..J~;~ IIC( 2...____
(prin.t Name of Officer)
(Date)