HomeMy WebLinkAbout0126136-HVAC (a/c)
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OSHKOSH
ON THE WATER
Job Address 206-212 ALGOMA BLVD
CITY OF OSHKOSH
No
126136
HV AC PERMIT - APPLICATION AND RECORD
Owner REG DOMESTIC ABUSE SERVICE INC
Create Date 08/07/2007
Contractor
Fuel
E C MERRILL INC
U Gas
o New
Category 511 - Ind. & Comm-Air Conditioning
Plan
UOiI
U Electric
o Replace
U Steam I
U Suppl. I
l.!J AlC ]
U Con. BurneU
U Solar
U Solid
System
U Forced Air U Radiant
W~~__-.J U Hot Water
Chimney Type D Chimney A ---u Chimney B
Heat Loss KJ As Approved () Existing
~Direct Vent
_ . Not Applicable
BTU Rate
o As Per Plan
() Variable-
. Not Applica~=:=J Value
=--<5tfier ---=:J Value
Use/Nature ICOMM / REPLACE AlC SYSTEM FOR 2ND FLOOR, EIV SIGNED BY WITZKE ELECTRIC
of Work (1~)
Feos' valua~953.00
Issued By:
Plan Approval $0.00
Permit Fee Paid ____ $145.00
Date 08/07/2007
D Permit Voide9J
Parcelld # 0701280000
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 thispermit application within an easement, the City strongly urges the permit applicant to contact the easement
holder(s) and 0 secure a ~y..'lls bef re starting such activity.
Signature
Date S"")-C17
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 ofInspection Services
P.O. Bo~ 1130 !
Oshkosh, WI 54903-1130
Phone (920) 236,5050
Fax (920) 236-~084
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OJHKOJH
ON THE WATFiR
HVACPERMIT APPLICATION ; I
All information after bold categories must be provided. ! I
.' . Incomplete applications will not be pr?cessed.. · i
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. Applicatiorl(s) and fee(s) can be brought to City Hall, Rooni 205 or mailed t~ Inspection Services, PO BO~ 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. : !'!
lOR! !
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If'vou are a contractor participatinJ! in the Permit fee Account System and have adequate funds.' check here
if ,ou want thr' "rocessed through vour aceount n ..' ~ ~. , !
, I . i DATE' ff LJ LfJ /), i
JOB ADDRE~S '2 [) 0 tfL-f; o~ 4! 7J I.- V D . I ; i
OWNER d:Jf/L-tjTINIF . 4)./1\'/' C~..v{(Z<<-C i
CONTRACT6R C -c. #112 /LIL II- c. / / V C-
. . :/
CHECK Ii1 ALL APPLICABLE
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USE CATEGORY
DSingle Familly
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, DDuplex . ~Mu1ti-Family
DRental
OCqrnmercial
OIndustrial
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FUEL
Dqas
DOil
DElectric DSolid
o Solar
SYSTEM
ONew
DOther
~eplace
TYPE
DForce,d Air : DRadiant DSteam)yAle. DVent DE~e/! DHot ~ater QSuppl.
IS C)llMNEyiBEING LIl'iED t;lNo DYes : ~INER SlZEJ/;.!r- & M~ ACtu=
Note: All chirnne,Ys shall be slZed per the BTU's bem~ vented. . i ·
DCon. BUrner
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CHIMNEY TYPE
HEATLOSS .
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BTURATE I
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DESCRIPTIO~ OF ALL WORK BEING DONE
7~ IA eI i pc-oorL .
DChimney A
DAs Approved
DAs Per Plan
DChimney B
DExisting
OVariable
DDirect VeIl.t : DOther
DNot Applicable '
DOther Value
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(-z? IJ.- ;
. 1:.1&,0 L-t4t.-/2
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A/c:) 515rFtW)
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VALUE (Inclu~ing labor and all materials includ~;ng light fixtures.) $ rt 9;j~ _ ~ : i
ELEC'tRIC.u CONTRACTOR WI '"IT21L fZ.-- '! : i
~or applicable projects, an Electri~ Ins~allation Verifi9ati~n fonn,~:s~~~d by.theElectrical Contract~t, must be
attachef' If not attached or not apphcab~e, a separate Electncal Penmt lSi reqUIred. . ;
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I 9/02
AUG. .2007 3:58PM. WITZkE E~ECTRIC.
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City otOslllcol!l :, :
bmsioQ o'1aspeod~ ktYicQ
215 ctnucbAWllQeI !
~W 1\30 I
osblcGll\ WI S4903~ 1130
Oft'iJ:1l 920-2364otQ ,
rax 92o.~6.'Dl4 I I
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Electric Installation V~rUleation
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:1. ~, '. i "'. ,! ,'. ;'~
i(We)~l~~ JS{~c/'lQ~~
I I i (Electrical Contractor ~ame)
,l55 E.l'akAvenLte.. Qshk.oSh
(Address) I I I (City) (State) (~ip Code)
have been contract~d to pedorm electric insta.Ua.tio~ wcr~ for (!/l nS:h ~ /J" n fJt!J1-ir I
I , (Name of party contracted to) ,
althefOJlowing~,{~lIeffiIJ)~() Alf/MIA. ~vd, :'
i (Address where work will be performed) 'I
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51f90:( ,
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~he nature of the work con,sists Clf~ (Check One or Descrl,be the Nature of Work)
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Reconnection' or new circuit for replacement Heating Pl~t and/or NC Condenser.
Reconnection or new circuit for replacement Electric Water Heater or pow~r vented
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R.econnection of'the Servioe ~ntrance Cable, Meter Box,a1terations to rec~ptacles
and lighting fixtures due to siding I sofl'it installation.. Note: New SetV;ioe
Entrance Cables will require a separate pennit. Ii
RecQrinection or . new circuit for the replacethent of otherpennanently wir~d
appliances I fixtures, I I . '
New circuit for the addition of Ale to an individual dwelling unit (house ot the
individual systems in a duplex or condominium). inclUding required SeMce
el~trlcal ciutlet$, . I
other'l
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-----
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he value of this work is $.: $,1)0
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thereby verlfy this I work will be performed by an emploYee of this company and tb.rthef: verify:,
the reconnection I installation will be done in compliance with manufaeturer and Electrib code '
taquitements. ' : I I "
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i (Signature of Company Officer)
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. (Print Namo of Officer)
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~~-4 7
(Date)