HomeMy WebLinkAbout0125777-HVAC (furnace; a/c)
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OSHKOSH
ON THE WATER
Job Address 1100 HERITAGE TRL
CITY OF OSHKOSH
No
125777
HVAC PERMIT -APPLICATION AND RECORD
Owner BRIAN SILlSA M HAAG
Create Date 07103/2007
Category 502 - Residential-Both
U Electric
o Replace
U Steam
I J Suppl.
Plan
U Solar U Solid
o Other
~ AlC U Vent
U Con. Burner
System
BREWER HEATING
~ Gas
D New
~ Forced Air
U Electric
Chimney Type KJ Chirnney A
Heat Loss KJ As Approved
BTU Rate KJ As Per Plan
Contractor
Fuel
UOH
U Radiant
U Hot Water
() Chimney B
() Existing
() Variable
. Direct Vent C) Not Applicable
. Not Applicable
. Other
Value
Value
UselNature SFR 1 Replace furnace & ale. Install 3" chimney liner. EIV piovided by Schommer Electric. **DEBIT ACCT**.
of Work
Fees: Valuation
$5,210.00
~
Plan Approval
$0.00
Permit Fee Paid
$89.50
Issued By:
Date 07/12/2007
o Permit Voided I
Parcelld # 1314590000
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
N8804 DOUGLAS ST
RIPON
WI 54971 - 9702 Telephone Number 920-748-6494866-8C
--
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.
:::07-07-03 08:24
:-: Cily of Oshkosh
-=- Division of!nsp<;cli<>n Services
PC). hox 1130
()~llkosh, WI 54003.1130
h('il~ (920) 236- ')050
: ;., (<J20) H:J-Slll-A
BRE'vVER
9207486520 >>
19202365084
P 1/1
~
D71~'l("CJJI I
ON 1 H~ WilT!- ~
HVAC PERMIT APPLICATION
All information after bold calegories must be provided,
Incomplete applications will not be processed,
· Application(5) .md ftc(s) can be brouglit to City Ibll, Room 205 or mailed to Inspcction Services, PO Box 1128,
O.<.ihkosh WI ~4903-] I ::!.b_ Conn~rh'jng Wvt1; w;\bo'Jt pcrm;t(s) will result in fees being doub;ed or $ ]'JO.OO plus the
l10mml pc-fm:l fet, whi'~:n eveT is ~.::~a1<..;7'.
i)l~
L""lLH"..e._,.""" .",> "'.""C'J1l!."!lL-",-!~<J:, ""1" AC"oun' Srmm "nd ho'" .<i'qua,,- (u,d,. chak hm
If-J.'!ilJ 'wa n t r h 1.\' P .t"ll (f'S ,\ I?d T h rOll r I; \'.:i Ii,. n ('::'!.!.JL'..d .
DATE 7-'3- u;
JOBADDR}:SS I/o\) #"-.+1'17- ~l-/
(';\\'NER-&~-u V' _"__H4~~
CO~TRACTOR.__~CLr::~ tI" ~ 7Z'7Vt; J::y, c.
CHECK ft1 ALL APPLICABLE
USE CATEGORY
~ing]e Falluly DDuplcx DMulti-Family
DRcntal
o Conm1ercial
o Indl.1strial
FUEL
~s
DOil
DElectric DSalid
o Solar
SYSTEM
DNew
DOthc...,
~eplace
TYPE
porced Air DRadiant OSteam ~C DVent OElectric DHot Water DSuppl. DCan. Burner
3/1 .
IS CHIMNEY BEING I"INED DNo DYes - LINER SIZE yZS- & MANUFACTURER
Note: All chimneys shall be sized per the BnJ's being vented.
CffiMNEY TYPE
IffiA T LOSS
BTU RATE
DChimney A
DAs Approved
DAs Per Plan
DChimney B
DExisting
OVariablc
,eDircct Vent DOther
DNot Applicable
Dather Value
DESCIUPTION OF ALL WORK BEING DOm:: ~ V"..,,~ ..:r ~I L
iZ..1~U mtd
I
VALUE.
$ 6;)./0 tN
--------r
ELECTRICAL CONTRACTOR S:~ €J'I!"e.+Y. '- q;;b' ?'!:,/.... 1.?,tJ)
fJ For applicable projects, an Electric Installation Verification form, signed by the Electrical Contractor, must be
a~~I;dc-~~dO~~~~p~abl~:;-te ~C'~~_t ~:equ:t_ ?9. 0lJ
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City !)ro.d,k~~
J:li~llm llf~Don Scrvi~c:i
215 Ch\IZ'Ch A'iCIlIIC
POBOJI 1130
Osl\Jl:osb WI 54I1u3.1130
ClfliGC Y2u'2J6'~U>U
ro.( ~1C1.2'6.S0H4
Electric Installation Verification
I (We)' Schommer Electrical Contra~ln~. Inc. <SEe.. Inc.)
(Electrical Contractor Name)
N164 Two Mile Rd~
'(Address) ,
Appleton
(City)
WI
(State)
54913
(Zip Code)
have been contracled to perform electric installation work fot:' Brewer Heating
(Name ofparty contracted to)
at the following :trldress:
1100 Herita~e Trail
(Address where work will be performed)
The nature of the work cotl5ists of: (Check One or Describe the Namre of Work)
7-
Re<:onnecti.on or new circuir for replacement Heating Plant and/or Ale COlldenser,
Reconnection or new circuit fOT replacement Electric Watf:! Heater or power vented
water 'heater.
Reco'nnection of the Service 'Entr;mce Cable, Meter Box~ alterat;ons to receptacles
and lighting fixtures due to siding I soffit installation. Note: New Service
Enuance Cables will require a separate pennit.
Reconncction or new circuit for the replacement of other permanently wired
a.ppliances I fixtures.
New circuit for the addition of Ale to an individual dwelling unit (house or the
individual systems in a. duplex or condominium). including required service
eLectrical outlets.
Other
The value <> f this work is $ 75.00
I hereby verify this work will be performed by an employee of this company and further verify
the r~connection I installa.tion will be done in compliance with manufacturcr and Electric code
requirements.
f?!Jf)~
lZ8ct4,.:; r"fOwlJHflL.-
(Print Name of Officer)
ir1
(D te)
(Signature of Company Officc.r)
e0/e0'd 0e6
S/02
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