HomeMy WebLinkAbout0125428-HVAC (a/c)
G
OSHKOSH
ON THE WATER
Job Address 3250 ISAAC LN
CITY OF OSHKOSH
No
125428
HV AC PERMIT - APPLICATION AND RECORD
Owner JEAN F WALD
Create Date 06/18/2007
Contractor MARTENS HEATING & COOLING
Fuel I J Gas UOil
System o New -~
U Forced Air U Radiant
U Electric U Hot Water
Chimney Type () Chimney A () Chimney B
Heat Loss :0 As Approved o Existing
BTU Rate o As Per Plan o Variable
Category 501 - Residential-Air Conditioning Plan
~ Electric I
o Replace
U Steam
U Suppl.
~ Direct Vent
U Solar
I
-.J
==
~NC I
U Con. Burner I
. Not Applicable
. Not Applicable
. Other
Use/Nature SFRI LATE PERMIT/INSTALL CENTRAL AIR UNIT, EIV SIGNED BY D. KAL ELECTRIC
of Work
Value
Value
~
J
Fees: Valuation $2,653.00
Issued By: ~fYY)~
Plan Approval
$0.00
Permit Fee Paid
$50.50
Date 06/21/2007
o Permit Voided I
Parcelld # 1416584400
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
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, VVI54903-1130
Phone (920) 236-5050
Fax (920) 236-5084
~
DEPARTMENT OF ufHV10ifH
COMMUNITY DEVELOPMENT N .
ON THE WATER
HV AC PERMIT ~lfit:reA1~d~S DIVISION
I
JUN 2 1 2007
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
If vou are a contractor participating in the Permit fee Account System and have adequate funds, check here
if vou want this processed through vour account n
?~S'o
JOB ADDRESS J
OWNERJec'tV\ WC/ 101
CONTRACTOR (YJ Ci r f {;"<15 If-Pel {'., <;
I
DATE (; ,IF,( C) 7
I So,q C
L",
1- (G d J ,i '7 ,
'\
CHECK ~ ALL APPlJCABLE
USE.CATEGORY
[3gfngle Family DDuplex DMulti-Family
o Rental
DCommercial
o Industrial
FUEL
o Gas
DOil
GErectric OSolid
o Solar
SYSTEM
DNew
DOther
OReplace
TYPE
DForced Air DRadiant OSteam DAle OVent OElecmc OHot Water DSuppl.OCon. Burner
IS CHIMNEY BEING LINEDCIlNo DYes ~ LINER SIZE
Note: AU chimneys shall be sized per the BTU's be~ng vented,
& MANUF ACTIJRER
CIDMNEY TYPE
HEAT LOSS
BTU RATE
DChimney A
DAs Approved
DAs Per Plan
DChimney B
DExisting
DVariable
ODirect Vent GOther
DNot Applicable
DOther Value
DESCRIPTION OF ALL WORK BEING DONE .I Y\ s;'G, II C (! -1 T f' '" I c\, r
VALUE (Ineluding labor and all IDSltel'ials including light fixtures) $ ,j 6' Cu, C)\:)
ELECTRICAL CONTRACTOR OR 0 Electric InstaUation Verification fcOrm attacbed(lfReplacement)
Elecllical installation ofnewkeplacemem equipment shall be done by licensed contl"actors
C heck -...u it L ri 0,~1(:; (j, i,,, 1 e /"'-
3/02
Ow "fO~I1k.<>$"
If)n~siQK'l .f.~f JI7,~)Cl~~jon St,'rvlr.c~
115 Cl~,,,,,,h ,Ave,,,,e
PO Jil,ox 1130
O!ihilosll WI 5490:2. II 30
O~ 'l20-7.3fo.5050
fax 9~.'.O.23(;.~;)M
I
JUN 2 1 2007
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
Electric.hu~tanatioD VerifieaOOD
(I) (We) __.__.Q_L._- fs.2J_____ ~-L_~-~:tr:..:.~-'=---..-.-.-.---
(ElectricaR CO'.otractoK Name)
__.'1:iO..3-~~._~-.?~-f~..c_L._g-::>~ -__.._.--9 ~.~C-9-__~~~Yf_f3.
(Address) (City) (State) (Zip Code)
have been contracted t.o perform deetrif; in.~~tanation work for _-,:J..!:i.~__~.s..(/ ----------.~
(N:ame: ofpmy contracted to)
at the foBowing address:_.U.:?'_~_____--,,;[:_~..~a c..._h~-______-_~-._-----------
(Ad(ln;~ss where work 'win be performed)
The natu'['o ofthe w'ork lCom:ists. of: (Che,;;:k One or Descrihe the Nawre of Work)
_L Reco:ooe~~ion or KM;::'~1V circuit for repblcernent He:a,t.blg Plant and/or Ale Con<ienser,
Recornnection or Ue'lJ\! circuit for replace:l.'llel'nt Electric Water Heatt;':f.
Recomlection of the Service Entrance Cable, M,eter Box, :alteratiQ.ilS to receptacles and
lighting fixn~:res due to s.idil1g I soffit installatioll. Note: New Service Entrance
Cables win require Zl seI\JI~Lrate pcnnit.
Reoonn'Oction or new circli.:it f.or otber perrnanently wired appliances! fixtures.
Other
_._____.__..._.___.~__._~.."......__'_.....~,.....,_.._..,,___.._.__.,,~._,..__~m_"""""_'''-'__'_~_'''~''_''-''_-''''--'-'-'''___-.-----.
---_._-.-....,........,._."-_.....-_.,-,_.._---~..._.~-~-_......,..._._-~~--.--.......,._------~_._....--,.-..""_.....-,.-._-_...............--------_._.----
The valut~ oOhis work is $..___L~Q.J__@.___.
I herehy verifY this work wm be perfOflJo.ed by an em.ployee of this company and further verify the
reconnectio:r!. / instaUa,Hon wm be done nn comt')hance '\1\{]th manufacturer and Electric code
requirements.
(] -JJj-~
#~c~mpa(jr~YOffiCer)
_~Ott\;~L!::~J~~ 114..:i_.__
(Print Name of Officer)
b 't c.) "7
------(----.r---~........
(Date)