HomeMy WebLinkAbout0125336-HVAC (furance & a/c)
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OSHKOSH
ON THE WATER
Job Address 933 STARBOARD CT
CITY OF OSHKOSH
No
125336
HVAC PERMIT - APPLICATION AND RECORD
Owner CARL B/CHRISTINE A TOWER
Create Date 06/14/2007
Category 502 - Residential-Both
U Electric
o Replace
U Steam
U Suppl.
Plan
Contractor BLACK-HAAK HEATING
Fuel ~ Gas UOil
System D New
~ Forced Air U Radiant
U Electric U Hot Water
Chimney Type KJ Chimney A () Chimney B
Heat Loss K:) As Approved . Existing
BTU Rate K:) As Per Plan . Variable
U Solar U Solid
D Other
~ AlC U Vent
l~ Con. Burner
. Direct Vent () Not Applicable
() Not Applicable Value
o Other Value
Use/Nature ~FR / Replace furnace & a/c. Install 3" chimney liner. EIV provided by Diersen Electric.
of Work
Fees: Valuation
$7,000.00
~
Plan Approval
$0.00
Permit Fee Paid
$115.00
Date 06/14/2007
Issued By:
D Permit Voided I
Parcel Id # 1522540000
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 7075
APPLETON
WI 54912 -7075 Telephone Number 920-757-9990
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
Fax (920) 236-5084
~
OfHKOfH
ON Tl-lE wATF.R
HVAC PERMIT APPLICATION
All information after bold categories must be provided.
Incomplete applications wil} not be processed.
. App1ication(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 Svstem and have ade
if vou want this vrocessed throuf!Jt vour account n
check here
JOBADDRESS ~'O3 stCtrbol>trd ()I-. \ DSn\LO~h
OWNER OOJL1D\Ater
CONTRACTOR ~\(lLVl+\CtLU1 ~-fJl-nn~}JJ1C: '
DATE~
CHECK ltI ALL APPLICABLE
V~ CATEGORY
.12SSingle Family ODuplex OMulti-Family
ORental
OCommercial
OIndustrial
FUEL
j).(Gas
DOn
DElectric DSolid
DSalar
SYSTEM
DNew
o Other
~eplace
~~ed Air DRadiant DSteam '~C DVent DElectric
IS CH:llVIl'ffiY BEING LINED DNa M:Yes - LINER SIZE b \\
Note: All chimneys shall be sized per the BTU's being vented.
DHot Water DSuppl. DCon. Burner
&MANUFACTURER~
CHIMNEY TYPE
HEAT LOSS
BTU RATE
DChirnney A
DAs Approved
DAs Per Plan
DChimney B
~. . x. isting
~Variable
)Spirect Vent o Other
DNat Applicable
OOther Value
DESCRIPTION OF ALL WORK BEING DONE ~i~marpj II il(J cUr cvooLi-hia,u'
to\WiA/\) DN~ . .
(DO
,?-exmt.+ 1t e ;
~161DD
ontractor, must be
JUN 1 4 Z007
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
l2
~~
\1;0
9/02
~
OJHKOfH
ON THE WATER
City of Oshkosh
Division ofInspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54902-1 130
Office 920-236-5050
Fax 920-236-5084
Electric Installation Verification
(1) (We)
b\ tY~Qflffihi('; L It, .
(Electrical ConJactor Name)
~6 tttn-rnu\
(Address)
~\)\(\n econ~~~~:L
(City) . (State)
54cmP
(Zip Code)
(Name of party contracted to
at the following address: q;Qo Ht.axJ2a.aJ'c\ C+. \ ORhtDsh
(Address where work will be performed)
have been contracted to perform electric installation work for
The nature of the work consists of: (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Heating Plant and/or AlC Condenser.
Reconnection or new circuit for replacement Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding / soffit installation. Note: New Service Entrance
Cables will require a separate permit.
Reconnection or new circuit for other permanently wired appliances / fixtures.
Other
JUN 14 Z007
h I f h' k' $ DEPARTMENT OF
T e va ue 0 t IS wor IS COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection / installation will be done in compliance with manufacturer and Electric code
requirements.
S~+t.. DI~~vs:t~
(Print Name of Officer)
~-/Z,,.o 7
(Date)