HomeMy WebLinkAbout0125914-HVAC (a/c)
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OSHKOSH
ON THE WATER
Job Address 714 FRANKLIN ST
CITY OF OSHKOSH
No
125914
HVAC PERMIT - APPLICATION AND RECORD
Owner MARALYN J ZWICKY
Create Date 07/23/2007
Contractor BLACK-HAAK HEATING
Fuel U Gas UOil
System D New
U Forced Air U Radiant
U Electric U Hot Water
Chimney Type D Chimney A () Chimney B
Heat loss () As Approved () Existing
BTU Rate () As Per Plan () Variable
Category 501 - Residential-Air Conditioning
Plan
U Solar U Solid
D Other
~ NC U Vent
U Con. Burner
. Not Applicable
~ Electric
~ Replace
U Steam
U Suppl.
() Direct Vent
. Not Applicable
. Other
Value
Value
24,000
Use/Nature SFR / Replace a/c. EIV provided by Krueger Electric.
of Work
Fees: Valuation
$2,900.00
()~
Plan Approval
$0.00
Permit Fee Paid
$53.50
Issued By:
Date 07/23/2007
D Permit Voided I
Parcelld # 1005060000
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
AgenUOwner
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. E}ox 1130
o.shkosh, WI 54903-1130
-Phone (920) 236-5050
Fax (920) 236-5084
~
OfHKOfH
ON THE WATER
HVAC PERMIT APPLICATION
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
lfyou are a contractor lJarticivatinf! in the Permit fee Account Svstem and have adeauate funds. check here
if yOU want this vrocessed throuf!Jt your account n
JOB ADDRESS .. br\os h
OWNERJY\(Ut1~
CONTRACTO~~~C.
CHECK Ii! ALL APPLICABLE
U~E CATEGORY
~Single Family ODuplex OMulti-Family
DATE~
ORental
o Commercial
OIndustrial
FUEL
DGas
DOil
~ctric DSolid
DSolar
SYSTEM
DNew
DOther
9Replace
TYPE .J
DForced Air DRadiant DSteam I2lAlC OVent. OElectric OHot Water DSuppl.
IS CHIMNEY BEING L~NO DYes - LINER SIZE
Note: All chimneys shall be sized per the BTU's being vented.
CHIMNEY ~Chimney A OChimney B DDirect Vent DOther
HEAT LOS~- [JAs Approved DExisting DNot Applicablili \ . 12;iJ 1\
BTU RATE DAs Per Plan OVariable lilOther Value ~ 000 ~ ~
DESCRIPTION OF ALL WORK BEING DONE ~@ul ilifll1V' clInctbh bfJet .
DCon. Burner
& MANUFACTURER
(,
VALUE (Including labor and all matena.IS .inclUding light fixtures) $ &fi1M, 00 term~ lee
, ~ ~ -21., . 'J:J 63 SO
ELECTRICAL CONTRACTOR.~fi) n .. ~ I
o For applicable projects, an Electric Installation Verification orm, signed by the Electrical Contractor, must be
attached, Ifnot attached or not applicabie, a separate Electtical p~eE I VE 0 0" ,.J...
\ ~~
JUL 2 3 2007
DEPARTMENT OF
COMMUNITY DEVELOPMENT
INSPECTION SERVICES DIVISION
9/02
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Pili ;20.Z.'''-lO/l_
Electric Installation Verification
(I) (We) __"" Xrv. C'iiJV'" E (Qc..Av,' <:... ~~~ ~
. ( ctrical Contractor Name)
{l"o1 V'a_",J!?<,-b,ol!L k.d. Lt'H7e.. (j,..JL Ur.. .5Y/tio
(Addrcl's) (City) , (State) (Zip Cod.~)
have been cCr\tr:actfld topmann ckctric: ifL'1tallatlon work for ~a.~,",LtOJ'J 1JeLl11~~
(Name of party conlJ'1\ctod to)
at th~ following addrc:is: _ , l 'L\Jioo\d I' n L D~h \(Dsn
(Address where work -Mu be performed)
The n3tUl'C ofth~ work con.sist'" of; (Check One or Describe the Nature of Work)
Reconnection or new circuit for replacement Henting PInnt andlor .AJC Condenser,
Reconnection or new c;irruit for rcplac~ment Electric Watcx H<Jatcr.
RcccHmcct.ion of the Service Entrance Cable, Meter Box. alterations to receptacl('!R and
lighting fixtures due to sidmg,l soffit installa.tion. Npt~: New Service Entrance
CablCl1 will require a separate permit.
. -,.-/ Reconnection or new circuit for other permanently wired appliances I fiXlUfCS.
V Other .. .' , .
--. ~\(t ,~\( WOCll1l0f\Rf~ 8 Gt D
The Vf\Jllc of this work is $
\ DB (DO
f nereby yerify this wNk will be performed by an employee of this company 3t)d~urther 'Jcrify the
reconnectton / i.l1stalJalicm wdl be done in complinncc with manufacturer and Elcl;;mc code
requirements,
tJilcJ &-;i;o ./
(Si p;naturc o~m y Officer)
Wo., \ +c.f LJ, k r~~,...('"
(.Print Name of Offic
r,8 ':!!;''1'd
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