HomeMy WebLinkAbout0125253-HVAC (a/c)
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OSHKOSH
ON THE WATER
Job Address 1565 MARICOPA DR
CITY OF OSHKOSH
No
125253
HVAC PERMIT -APPLICATION AND RECORD
Owner DONALD R SIMONS/G M SCHAEFFER
Create Date 06/11/2007
Contractor E C MERRILL INC
Fuel U Gas UOil
System o New
U Forced Air U Radiant
U Electric U Hot Water
Chimney Type D Chimney A C) Chimney B
Heat Loss C) As Approved o Existing
BTU Rate C) As Per Plan o Variable
Category 501 - Residential-Air Conditioning
Plan
U Electric
o Replace
U Steam
U Suppl.
() Direct Vent
U Solar U Solid
D Other
l!J NC U Vent
U Con. Burner
. Not Applicable
. Not Applicable
. Other
Value
Value
Use/Nature SFR / Replace a/c. EIV provided by Witzke Electric.
of Work
Fees: Valuation
$3,310.00
aarvJ
Plan Approval
$0.00
Permit Fee Paid
$61.00
Date 06/11/2007
Issued By:
D Permit Voided I
Parcelld # 1319350000
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
1018 W SOUTH PARK AVE
OSHKOSH
WI 54902 - 0
Telephone Number (920) 235-3600
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.
City of Oshkosh
Division of Inspection Services
P.O. Box 1130
Oshkosh, WI 54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
OJHKOJ~1
ON THE WATFR .
: HVAC PERMIT APpLICATION
All information after bold categories must be provided.
, Incomplete applications will not be processed.
; . ; ;: i: :!.
· Application(s) and fee(s) can be brought to City Hall, Room 205 or mailed to Inspection Services,p6 'Box 1128,
Oshkosh WI 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which ever is 'greater. · "
'. .OR. !... . .' ... . . . ,:.' .
If you are a contractor particiTJatinf! in the Perfnit fee Accouht System 'and have adequate funds. i:h~ck here
if )IOU want this vrocessed throughJ.our account n '
1 - .
DATE
<P /S-/O.-,
I I .
JOB ADDRESS lL:jlPS- IV1 AILe GoY:> A
OWNER 7) 0;.../ > / MOtV ~
CONTRACTOR
CHECKItf ALL APPLICABLE
USE CATEGORY
~ngleFami1y DDuplex PMulti.-Family!
DRental
o Commercial
DIndustrial
FUEL
DGas
DOil
DElectric .DSolid
o Solar
SYSTEM
DNew
o Other
DReplace
TYPE
DForced Air
DRadiant ,DSteam
DA,JC
DVent
DElectric
DHot Wat7r DSuppl.
, .
Deon. Burner
" ,; ; ',i
IS CHIMNEY BEING LINED DNo DY~s - LINER SIZE
Note; All chimneys shall be sized per the .BTU's being vented.
, .:
~ . i
.,.1 . _.,"
& MANtiFACfvREn.'
I
CmMNEY TYPE
REA T LOSS
BTU RATE
;
DChimney A
DAs Approved
DAs Per Plan
DChimney B
DExisting
DVariable
DDirect Vent bOther
DNot Applicable
DOther Value
DESCRIPTION OF ALL WORK BEING DOl'l'E
?) fi?-~t-A~~ ale-.
.
JUN 11 2007
DEPARTMENT OF
COM~lUNIT{ DEVELOPMENT .
INSPECTION SEp\!Kr:~ DIVISION
'''. ~
VALUE (Includln. labnr and aU materais Includln. U.~t fixture.) ~. 4I3~b. o~ \;).0~{> /, /, !f.J/
ELECTRICAL CONTRACTOR : tvI72,1:;it-. . ..'
~or applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
attached. If not attached or not applicable, a separate Electrical Permit is required. .
JUN. 8.2007 8:04AM
WrrZKE ELECTRIC .
NO. 072 P.l ,
"
.. .,' I
:~.
~
c~otO!J>>W!IlI ;
DIvislon oflnspecdQn ~
215Chun:hAvel\1lei
PO Box 1130 '
OslIkashWI S4903-1130
Office 92Q.23ioSD$O
F:ilI 92ll-.2J1l-SOll4
Electric Installation Veritication
l(We)~ J;(rX!r\c,' Inc.
. (Electrical Contractor Name)
155 E. t>ac.k.er A\leJ)ue-.Oshk..osh
(Address) (City) (State)
have!been contracted to perform electric installation work forbt tltrrlll
(Name of party contracted to)
lIttherOUowingaddress;(1vnSt-J 15b5 ~_rtCORL .
:. (Address where work will pe performed)
WL
5Jf90(
(Zip Code)
The nature of the work consists of: (Check One or Descri:he the Nature ofWoIk)
X Reconnection or new circuit for replacement Heating Plant and/or Ale Condenser.
Reconnection or new circuit for replacement Electric Water Heater or power vented
water heater.
Reconnection of the Service Entrance Cable, Meter Box,alterations to receptacles
and lighting fixtures due tq siding / soffit installation. Note: New Service
Entrance Cables will require a separate permit.. '
Reconnection or new circuit for the replacement of other permanently wired
appliances I fixtures. . ..
New circuit for the addition of Ale to an individual dwelling unit (house or the
individual systems in a duplex or condominium)t including required service
electrical outlets.
Oili~ ~
JUN 11 Z007
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SER\lICES DIVISION
The .value of this work is $ j 1).5"- 0 D
I hereby verify this work will be perfonned by an employee of this company and further verifY
the reconnection I installation will be done in compliance with manufacturer and Electric code
requirements.
w-~~:~_ &O~
(Signature of Company Officer)
~'r\ a\~
(Print Name of Officer) ,.
6..J"()7
(Date)
Sll)2